Insight in schizophrenia–course and predictors during the acute treatment phase of patients suffering from a schizophrenia spectrum disorder

Abstract

The revealed predictors might function as treatment targets in order to improve insight and with it outcome of schizophrenia.

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

“…There is evidence that changes in insight in the chronic phase of the illness is related to clinical factors such as symptom severity and treatment setting (Quee et al, 2013). As to be expected, there is evidence that insight improves during hospitalization in a heterogeneous sample of people with psychotic disorders, with insight stabilizing after discharge (Schennach et al, 2012). However, general improvement of symptoms was not taken into account in this study, leaving unclear how specific results are.…”

The effects of aging on insight into illness in schizophrenia: a review

“…Explanations for this difference included the following: acceptance of illness by chronic patients (psychological model); greater psychological defensiveness by the first‐episode patients (psychological model); lack of education or knowledge about schizophrenia during the first episode of psychosis (psychoeducation model); and a longer time undergoing treatment (clinical/psychopathological model). In one study, although the multi‐episode group had greater insight into illness at the time of admission, first‐episode patients had significantly greater improvement in insight during the acute phase of treatment and at the time of discharge (Schennach et al ., ), which suggests that first‐episode patients (and possibly younger patients) may have a greater capacity for developing insight into illness than those in later phases of schizophrenia. This idea is supported by another study, in which younger patients experienced greater changes in insight into illness during a psychotic episode (Chen et al ., ).…”

Quality of life in schizophrenia spectrum disorders: Associations with insight and psychopathology

“…These theories, as already mentioned, conceptualize unawareness as being a form of denial, reflecting a psychological defense mechanism (Moore et al, 1999;Crumlish et al, 2005) or a cognitive strategy, where patients are aware of their illness in some sense, but are motivated to deceive themselves in order to preserve their self-esteem and maintain a positive outlook (Startup, 1996). Good insight has been found in several studies to correlate positively with depressive symptoms in the early or acute phase of psychosis, as well as in chronic and stable psychoses (Cooke et al, 2005;Saeedi et al, 2007;Schennach, 2012). This association has also been confirmed in a meta-analysis covering the previous 20 years of published data (Mintz et al, 2003).…”