A deeper view of insight in schizophrenia: Insight dimensions, unawareness and misattribution of particular symptoms and its relation with psychopathological factors
Abstract
Objective 1. To describe insight in a large sample of schizophrenia subjects from a multidimensional point of view, including unawareness of general insight dimensions as well as unawareness and misattribution of particular symptoms. 2. To explore the relationship between unawareness and clinical and socio-demographic variables.Methods 248 schizophrenia patients were assessed with the Positive and Negative Syndrome Scale (PANSS, five factor model of Lindenmayer) and the full Scale of Unawareness of Mental Disorder (SUMD). Bivariate associations and multiple linear regression analyses were used to investigate the relationship between unawareness, symptoms and socio-demographic variables.Results Around 40% of the sample showed unawareness of mental disorder, of the need for medication and of the social consequences. Levels of unawareness and misattribution of particular symptoms varied considerably. General unawareness dimensions showed small significant correlations with positive, cognitive and excitement factors of psychopathology, whereas these symptom factors showed higher correlations with unawareness of particular symptoms. Similarly, regression models showed a small significant predictive value of positive symptoms in the three general unawareness dimensions while a moderate one in the prediction of particular symptoms. Misattribution showed no significant correlations with any symptom factors.Conclusions Results confirm that insight in schizophrenia is a multi-phased phenomenon and that unawareness into particular symptoms varies widely. The overlap between unawareness dimensions and psychopathology is small and seems to be restricted to positive and cognitive symptoms, supporting the accounts from cognitive neurosciences that suggest that besides basic cognition poor insight may be in part a failure of self-reflection or strategic metacognition.
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Poor clinical insight is associated with positive symptoms.
“Literature supporting this includes studies correlating poor clinical insight with overall symptom severity [43][44][45] , positive symptoms 46,47 , negative symptoms 44,48,49 , disorganization symptoms 46,47,50-52 , and excitement symptoms 46,47,53 .”
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 [46]
Poor clinical insight is associated with excitement symptoms.
“Literature supporting this includes studies correlating poor clinical insight with overall symptom severity [43][44][45] , positive symptoms 46,47 , negative symptoms 44,48,49 , disorganization symptoms 46,47,50-52 , and excitement symptoms 46,47,53 .”
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 [46]
Poor clinical insight is associated with disorganization symptoms.
“Literature supporting this includes studies correlating poor clinical insight with overall symptom severity [43][44][45] , positive symptoms 46,47 , negative symptoms 44,48,49 , disorganization symptoms 46,47,50-52 , and excitement symptoms 46,47,53 .”
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 [46]
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- Authors
- Pousa, E., Ochoa, S., Cobo, J., Nieto, L., Usall, J., Gonzalez, B., Garcia-Ribera, C., Pérez Solà, V., Ruiz, A.-I., Baños, I., Cobo, J., García-Ribera, C., González, B., Massons, C., Nieto, L., Monserrat, C., Ochoa, S., Pousa, E., Ruiz, A.-I., Ruiz, I., Sanchez-Cabezudo, D., & Usall, J.
- Affiliations
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Universitat Autònoma de Barcelona (ES)
- Hospital Del Mar (ES)
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 189
- Pages
- 61-68
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2589267879
- Cited by
- 37
- References
- 49
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 7 · 2017: 2
- FWCI
- 3.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- 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 › Psychoanalysis and Psychopathology Research
- Keywords
- insight, schizophrenia
- MeSH terms
- Adult, Awareness, Female, Humans, Male, Middle Aged, Prospective Studies, Psychometrics, Psychopathology, Psychotic Disorders, Surveys and Questionnaires, Regression Analysis, Schizophrenia, Schizophrenic Psychology
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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