Predictors of insight in first-episode schizophrenia: A 5-year cohort study from India

Abstract

These findings argue that insight and explanatory models of illness are secondary to psychopathology, course and outcome. They are dependent on the trajectory of the person's illness, are not independent of the condition and call for multifaceted understanding of the issues.

Insight in psychosis: An independent predictor of outcome or an explanatory model of illness?

“…severe illness with poor outcome predicting ''poor insight'' and non-medical EMs). Nevertheless, recent investigations, which have systematically elicited prevalent EMs, have reported that good insight has also been positively associated with the number of nonmedical EMs of illness (Johnson et al, 2012(Johnson et al, , 2013. They also suggest that holding non-medical EMs, does not necessarily imply that they do not subscribe to medical EMs.…”

“…Many reports, which have systematically elicited EMs, have documented the presence of multiple and contradictory beliefs about illness across cultures (Kapoor, 1975;Gater et al, 1991;Lloyd et al, 1998;Joel et al, 2003;McCabe and Priebe, 2004;Saravanan et al, 2007aSaravanan et al, ,b, 2010Johnson et al, 2012Johnson et al, , 2013Johnson et al, , 2014. EMs are usually a conglomeration of emic and etic approaches involving ethnocultural, personal and idiosyncratic beliefs and components from both within and outside culture.…”

“…Pluralistic societies employ multiple approaches to health and illness (Jacob, 1999). The fact that people with non-medical beliefs regularly take psychotropic medication (Saravanan et al, 2007a(Saravanan et al, ,b, 2010Johnson et al, 2012Johnson et al, , 2013Johnson et al, , 2014 argues for the complexity of the response to chronic and disabling illness. Research has documented a complex list of reasons and circumstances, which facilitate medication compliance and which are not necessarily voluntary or rational (Tranulis et al, 2011).…”

“…Recent studies, which have examined known risk factors of poor outcome, have suggested that they confound the impact of insight on illness course and progression (Johnson et al, 2012(Johnson et al, , 2013(Johnson et al, , 2014. These studies have demonstrated that insight predicted clinical states later in the course of illness when examined in isolation.…”

“…Investigations, which have examined the relationship between insight, psychopathology and EMs over time, document a complex reality (Johnson et al, 2012(Johnson et al, , 2013. Serial assessments of insight, EMs and psychopathology document different progressions.…”