Effects on cognitive and clinical insight with the use of Guided Self-Determination in outpatients with schizophrenia: A randomized open trial
Abstract
Poor insight has a negative impact on the outcome in schizophrenia; consequently, poor insight is a logical target for treatment. However, neither medication nor psychosocial interventions have been demonstrated to improve poor insight. A method originally designed for diabetes patients to improve their illness management, Guided Self-Determination (GSD), has been adapted for use in patients with schizophrenia (GSD-SZ). The purpose of this study was to investigate the effect on insight of GSD-SZ as a supplement to treatment as usual (TAU) as compared to TAU alone in outpatients diagnosed with schizophrenia. The design was an open randomized trial. The primary hypothesis was cognitive insight would improve in those patients who received GSD-SZ + TAU as assessed by the BCIS. We additionally explored whether the intervention led to changes in clinical insight, self-perceived recovery, self-esteem, social functioning and symptom severity. Assessments were conducted at baseline, and at 3-, 6- and 12-month follow-up. Analysis was based on the principles of intention to treat and potential confounders were taken into account through applying a multivariate approach. A total of 101 participants were randomized to GSD-SZ + TAU ( n = 50) or to TAU alone ( n = 51). No statistically significant differences were found on the cognitive insight. However, at 12-month follow-up, clinical insight (measured by G12 from the Positive and Negative Syndrome Scale), symptom severity, and social functioning had statistically significantly improved in the intervention group as compared to the control group. “Improving insight in patients diagnosed with schizophrenia”, NCT01282307, http://clinicaltrials.gov/ .
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Guided self-determination is reported to improve insight relative to treatment as usual.
“Other psychological therapies that have also been reported to lead to improvement in insight relative to treatment as usual include integrated psychological therapy 170 , a self-management skills program 171 , and an adaptation to schizophrenia of an individualized treatment developed to help adults with diabetes accept their medical condition, called guided self-determination 172 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [172]
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- Authors
- Jørgensen, R., Licht, R. W., Lysaker, P. H., Munk-Jørgensen, P., Buck, K. D., Jensen, S. O. W., Hansson, L., & Zoffmann, V.
- Affiliations
- Aalborg University Hospital (DK)
- Richard L. Roudebush VA Medical Center (US)
- Lund University (SE)
- Copenhagen University Hospital (DK)
- Corresponding author
- Jørgensen, R.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-07
- Volume
- 30
- Issue
- 5
- Pages
- 655-663
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2121871651
- Cited by
- 35
- References
- 52
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 2
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Funders
- Aalborg Psychiatric Hospital
- Novo Nordisk Foundation
- Health Insurance Foundation
- TrygFonden
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- schizophrenia, clinical insight, cognitive insight, guided self-determination, illness management, self-determination, outpatients, usual care, symptom severity, social functioning, self-esteem, PANSS
- MeSH terms
- Adult, Ambulatory Care, Cognition, Female, Humans, Male, Middle Aged, Outpatients, Patient Participation, Schizophrenia, Schizophrenic Psychology, Self Care, Self Concept, Health Behavior, Treatment Outcome
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