Insight and Interpersonal Function in Schizophrenia

Abstract

Research has linked impaired insight in schizophrenia to poorer medication compliance and treatment outcome. It is unclear, however, whether poorer interpersonal function is also associated with impaired insight. To examine this question, subjects with schizophrenia or schizoaffective disorder were classified as having unimpaired (N = 44) or impaired (N = 57) insight, and their scores on Heinrichs et al.'s Quality of Life (QOL) Scale were compared. Multiple regressions were conducted to determine the relationship between individual components and social function. Results indicate that subjects with impaired insight had significantly poorer QOL interpersonal relation and intrapsychic foundation scores than unimpaired subjects, despite having equivalent deficit symptoms. Unawareness of the social consequences of illness was found to be the component of insight more closely linked to social dysfunction. This suggests that impairments in insight may be uniquely associated with social dysfunction.

Exploratory study of the association between insight and Theory of Mind (ToM) in stable schizophrenia patients

“…Se pueden utilizar períodos de tiempo más cortos o más largos para la valoración actual y retrospectiva de la conciencia y la atribución, dependiendo de los objetivos de la investigación. En los síntomas ítems (números [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] se debe valorar la comprensión del sujeto acerca de la causa de su síntoma (la atribución).…”

Insight and treatment outcome with cognitive-behavioral social skills training for older people

“…Post hoc analyses showed that reduction of insight-linked hopelessness might have accounted for the positive effect of CBSST on functioning compared with TAU. These findings along with prior research on the relationship between insight and hopelessness and depression [1,3] suggest that hopelessness may be an important clinical target in CBT for schizophrenia.…”

“…Given the established relationship between high insight and depression in people with schizophrenia [1,3], we conducted post hoc Chi-square and correlation analyses to explore the hypothesis that CBSST might have reduced the negative impact of insight-linked hopelessness on functioning compared with TAU, thus contributing to the moderation effect just described. In the total sample, greater insight (BIS) at follow-up was not significantly correlated with HAM-D total scores (r = 0.19, p = 0.15, n = 62), but was significantly correlated with greater hopelessness at follow-up (Spearman rank correlation r = 0.26, p = 0.04, n = 61).…”

“…Prior research has indicated that increased insight may be associated with more severe depression and hopelessness [1,3]. Older people who have suffered from schizophrenia for several decades may have faced many failure experiences and lifelong disability that could lead to hopelessness about attempting to improve functioning.…”

“…Greater insight is related to improved course of schizophrenia [1], improved social functioning [2][3], decreased rates of rehospitalization, and improved treatment adherence [4][5] but also to greater hopelessness, depressive symptoms [1,6], and suicide risk [7][8]. We previously reported that middle-aged and older people with schizophrenia who received group cognitive-behavioral social skills training (CBSST) had significantly greater self-reported everyday functioning and coping skills knowledge than those who received treatment as usual (TAU) [9].…”