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Is good insight associated with depression among patients with schizophrenia? Systematic review and meta-analysis

Belvederi Murri, Martino, Respino, Matteo, Innamorati, Marco, Cervetti, Alice, Calcagno, Pietro, Pompili, Maurizio, Lamis, Dorian A., Ghio, Lucio, Amore, Mario·2015·Schizophrenia Research

DOI 10.1016/j.schres.2015.01.003

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Abstract

Among patients with schizophrenia, better insight may be associated with depression, but the findings on this issue are mixed. We examined the association between insight and depression in schizophrenia by conducting a systematic review and meta-analysis. The meta-analysis was based on 59 correlational studies and showed that global clinical insight was associated weakly, but significantly with depression (effect size r=0.14), as were the insight into the mental disorder (r=0.14), insight into symptoms (r=0.14), and symptoms' attributions (r=0.17). Conversely, neither insight into the social consequences of the disorder nor into the need for treatment was associated with symptoms of depression. Better cognitive insight was significantly associated with higher levels of depression. The exploratory meta-regression showed that methodological factors (e.g. the instrument used to assess depression and the phase of the illness) can significantly influence the magnitude of the association between insight and depression. Moreover, results from longitudinal studies suggest that the relation between insight and depression might be stronger than what is observed at the cross-sectional level. Finally, internalized stigma, illness perception, recovery attitudes, ruminative style, and premorbid adjustment seem to be relevant moderators and/or mediators of the association between insight and depression. In conclusion, literature indicates that among patients with schizophrenia, better insight is associated with higher levels of depressive symptoms. Thus, interventions aimed at promoting patients' insight should take into account the clinical implications of these findings.

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Authors: Belvederi Murri, M., Respino, M., Innamorati, M., Cervetti, A., Calcagno, P., Pompili, M., Lamis, D. A., Ghio, L., & Amore, M.
Affiliations: University of Genoa (IT)
European University of Rome (IT)
Azienda Ospedaliera Sant'Andrea (IT)
Emory University (US)
ORCID: Belvederi Murri, Martino
Respino, Matteo
Innamorati, Marco
Calcagno, Pietro
Pompili, Maurizio
Lamis, Dorian A.
Amore, Mario
Venue: Schizophrenia Research
Publisher: Elsevier BV
Published: 2015-03
Volume: 162
Issue: 1-3
Pages: 234-247
ISSN: 0920-9964 (ISSN-L)
DOI: 10.1016/j.schres.2015.01.003
OpenAlex: W2096974104
Cited by: 142
References: 154
Citations by year: 2026: 9 · 2025: 13 · 2024: 10 · 2023: 16 · 2022: 18 · 2021: 12 · 2020: 12 · 2019: 15 · 2018: 10 · 2017: 12 · 2016: 13 · 2015: 2
FWCI: 1.70
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Schizophrenia Research (publishedVersion)
PubMed (publishedVersion)
CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: schizophrenia, insight
MeSH terms: Awareness, Depressive Disorder, Humans, Schizophrenia, Schizophrenic Psychology

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Is good insight associated with depression among patients with schizophrenia? Systematic review and meta-analysis

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