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Tijdschrift voor Psychiatrie 44 (2002) 5, 313 - 322

Review article

Lack of insight in schizophrenic patients: a review

N. Robben, M. De Hert, J. Peuskens

background Lack of insight is a common clinically used and examined concept.
aim This review gives an overview of the research which studied the different variables associated with insight.
method The different studies were collected by means of Medline and Psyclit. We reduced the number of articles by using English and Dutch language literature from 1990 until July 2000.
results Lack of insight is more prevalent in schizophrenic patients than in other diagnostic groups. Association with positive symptoms is present. The impact of neurocognitive dysfunctioning on insight is more and more highlighted. The higher the insight, the better the psychosocial functioning, the treatment compliance and the global outcome seem to be, indicating the importance of treatment strategies improving insight. Increasing insight is associated with depressed mood and an elevated risk for suicide.
conclusion Research results indicate a correlation between insight, positive symptoms and prognosis. The associations mentioned are only correlational, a statement about causality is not possible. Especially longitudinal studies, the use of a consistent definition of insight, and re-liable, valid instuments to measure insight are needed.

keywords insight, schizophrenia