Insight in Schizophrenia. Its Relationship to Acute Psychopathology

TLDR

The study examined the link between insight and acute psychopathology in 52 acutely psychotic schizophrenia patients, validating an insight measure against semi‑structured interview ratings and medication compliance. Insight did not consistently correlate with acute symptom severity or change, indicating that insight deficits are largely independent of acute psychopathology and resistant to neuroleptic treatment.

Abstract

The relationship between insight and acute psychopathology was explored in a group of 52 acutely psychotic, schizophrenic patients. A measure of insight, reflecting patients' recognition of their illness and need for care, was validated against ratings from a semi-structured interview and against assessments of patients' compliance with medication. Contrary to expectations, degree of insight was not consistently related to the severity of acute psychopathology, as measured on two structured scales. Nor did changes in insight during hospitalization vary consistently with changes in acute psychopathology. These data suggest that very little of the deficiency in insight seen in schizophrenic patients is explainable on the basis of acute psychopathological features. The mechanism that accounts for impairment in insight in schizophrenia may be relatively resistant to treatment with neuroleptic medication.