Insight in schizophrenia: a review of etiological models and supporting research

Poor insight in schizophrenia occurs across different cultures and at different phases of the illness.

“Poor insight in schizophrenia is prevalent across cultures and phases of illness.”

Poor insight is linked to poorer clinical outcomes.

“Poor insight has also long been linked to poorer clinical outcomes 10,13,17,42 , with the joint possibilities that symptoms cause poor insight, and that poor insight causes less treatment adherence which may result in more symptoms.”

Poor clinical insight in schizophrenia is associated with negative attitudes towards taking antipsychotic medication and the decision to decline pharmacological treatments.

“As noted above and elsewhere 10,13,17 , poor clinical insight in schizophrenia has long been associated with negative attitudes towards taking antipsychotic medication and the decision to decline pharmacological treatments.”

Poor insight may arise from anomalous experiences, such as the incomprehensibility and potentially traumatic nature of unusual experiences in schizophrenia.

“One challenge to the emergence of insight is the incomprehensibility and potentially traumatic nature of the unusual experiences which characterize schizophrenia 10 .”

Poor insight may arise from neurocognitive deficits in attention, memory and executive functioning.

“For instance, it is possible that deficits in attention, memory and executive functioning compromise individuals' abilities to access relevant memories about the experience of mental illness, to distinguish more from less salient aspects of those memories, to place those memories in sequence and to understand causal links 10,13 .”