Abstract
Background The objective of the present study was to examine the association of insight into the illness with demographic variables and symptomatology in a sample of 1213 patients with schizophrenia. Method Data were collected with the Psychosis Evaluation tool for Common use by Caregivers (PECC), a semi-structured interview evaluating five symptom domains of schizophrenia and the insight items ‘awareness of having a mental disorder’ and ‘attributing symptoms to a mental disorder’. Results Insight was positively associated with educational level and inversely with overall symptom severity, and the positive, negative, excitatory and cognitive symptom domains. At symptom level, the items ‘delusions’, ‘grandiosity’, ‘poor rapport’, ‘social withdrawal’ and ‘guilt feelings’ showed the strongest associations with both insight items. Overall, correlations between insight and symptomatology were modest, explaining less than 30% of the variance in insight. Conclusion Lack of insight in schizophrenia is partially explained by clinical symptoms and demographic measures.
Highlights
Poor insight into the illness is considered to be one of the most common features of schizophrenia [3,7]
A significant relationship between insight scores and gender was found, indicating that females had more impaired insight (AMI: t = 2.24, P = 0.0250; attributing their symptoms to a mental illness (ASAMI): t = 2.52, P = 0.0120). This association was mediated by significantly higher symptom scores in female patients (F(1.1211) = 10.73, P = 0.0011), as the effect of gender disappeared when symptomatology was taken into account
Educational level showed a significant association with both insight items, indicating that higher educational level was associated with better insight (AMI: R = À0.16, P = 0.0001; ASAMI: R = À0.15, P = 0.0001; a mental illness (AMI): F(5.1177) = 10.31, P < 0.0001; ASAMI: F(5.1177) = 9.54, P < 0.0001)
Summary
Poor insight into the illness is considered to be one of the most common features of schizophrenia [3,7]. Poor insight has a strong impact on clinical outcome [2,39], treatment compliance [6,22,39], social function [27] and rehabilitation outcomes [26]. The objective of the present study was to examine the association of insight into the illness with demographic variables and symptomatology in a sample of 1213 patients with schizophrenia. Results: Insight was positively associated with educational level and inversely with overall symptom severity, and the positive, negative, excitatory and cognitive symptom domains. Conclusion: Lack of insight in schizophrenia is partially explained by clinical symptoms and demographic measures.
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