What is insight in schizophrenia? 

Insight with regards to schizophrenia is defined as the awareness of having the disorder, including an understanding of the social consequences associated with the disorder; the need for treatment; effects of medication; awareness of the implications; and awareness of the signs and symptoms of the disorder. Clinical insight involves the awareness of the disorder and symptoms, while cognitive insight relates to the ability to question and consider one’s beliefs and judgements.

What is the evidence for insight?

Moderate quality evidence found more severe symptoms are related to lower levels of insight into the disorder and its consequences. Conversely, increased depression symptoms were related to increased levels of insight, and there was a small association between better insight and poorer quality of life.

Moderate to high quality evidence found small associations between better insight and higher IQ and better memory functioning. Moderate quality evidence found small associations between better insight and less aggression, better work and social functioning, increased treatment adherence, and fewer re-hospitalisations.

High quality evidence found a medium-size effect of more self-certainty in people at risk of psychosis compared to controls. Moderate quality evidence found no differences in self-reflectiveness or overall cognitive insight.

Moderate quality evidence found any treatment improves insight, particularly in combination with other treatments that target insight specifically.

February 2022

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Last updated at: 4:53 pm, 19th March 2022
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