Insight and quality of life in schizophrenia: recent findings and treatment implications

Abstract

Several studies have reported that patients with schizophrenia lack awareness of having a mental disorder or symptoms of a mental disorder. The concept of insight has long been considered important for engagement in treatment, psychotherapeutic progress and good prognosis. Contradictory results were found regarding the relationship between insight into illness and quality of life in patients with schizophrenia. Although previous studies found an inverse or no significant association, recent studies reported that greater insight into illness is significantly associated with an increase in depression and poor subjective quality of life. Patients with good insight might realize their restrictions more clearly. The stigma of being mentally ill and the need for treatment or hospitalization are serious psychological strains. The increase of depression and suicidal ideation and decrease in subjective quality of life in patients with better insight underline the importance of insight for the clinical course in schizophrenia. The inclusion of modules focussing on depressive symptoms and quality of life-related aspects to psychoeducational programmes, as well as a greater awareness of the physician for these questions and a strengthening of the therapeutic alliance, might help improve insight without the risk of deteriorating mood and quality of life.