Correlates and Long-Term Consequences of Poor Insight in Patients With Schizophrenia. A Systematic Review
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Between 50 and 80% of the patients diagnosed with schizophrenia have been shown to be partially or totally lacking insight into the presence of their mental disorder. Although a causal chain connecting poor insight with poor treatment adherence and thus with poorer outcome and functioning is straight forward, numerous studies investigating correlates and long-term impact of insight have provided differing results. In addition, higher levels of insight in schizophrenia have been associated with depression and hopelessness, but the causal direction of the relationship is unclear and the data are inconclusive. The current study provides a critical review of 88 studies on the assessment of insight and its impact on symptoms and functioning. Studies published by June 2006 were selected using a keyword search for English peer-reviewed articles in the databases PsycINFO and MEDLINE. The majority of studies support the assumption that insight is associated with adherence during treatment phase, but the association with long-term adherence remains unclear. Insight correlates with better long-term functioning, but this might be explained by its association with symptoms. There is a positive cross-sectional and longitudinal relationship between insight and depression, but the underlying processes need further clarification. In the concluding discussion, the problems relating to definition and study designs are considered responsible for many of the inconclusive findings. Suggestions for further research are derived.
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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.”
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 [17]
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.”
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 [17]
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Cognitive behaviour therapy for schizophrenia
Jones, C., Cormac, I., Silveira da Mota Neto, J. I., & Campbell, C. (2004) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000524.pub2 · Cited by 269 · see citing works
RetractedHamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817 · see citing works
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
Endicott, J. (1978) · Archives of General Psychiatry · doi:10.1001/archpsyc.1978.01770310043002 · Cited by 5,686 · see citing works
Ostwald, P. F. (1960) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1960.14.4.817 · Cited by 1,422 · see citing works
David, A. S. (1990) · The British Journal of Psychiatry · doi:10.1192/bjp.156.6.798 · Cited by 1,164 · see citing works
Assessment of insight in psychosis
AMADOR, X. F., Strauss, D. H., Yale, S. A., FLAUM, M. M., Endicott, J., & Gorman, J. M. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.6.873 · Cited by 1,100 · see citing works
Awareness of Illness in Schizophrenia and Schizoaffective and Mood Disorders
AMADOR, X. F. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950100074007 · Cited by 898 · see citing works
A new instrument for measuring insight: the Beck Cognitive Insight Scale
Beck, A. T. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(03)00189-0 · Cited by 871 · see citing works
A meta-analysis of randomized controlled trials: Efficacy of selenium treatment for sepsis
Li, S., Tang, T., Guo, P., Zou, Q., Ao, X., Hu, L., & Tan, L. (2019) · Medicine · doi:10.1097/md.0000000000014733 · Cited by 802 · see citing works
Leucht, S., Pitschel‐Walz, G., Abraham, D., & Kissling, W. (1999) · Schizophrenia Research · doi:10.1016/s0920-9964(98)00105-4 · Cited by 795 · see citing works
The Brown assessment of beliefs scale: Reliability and validity
Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., Atala, K. D., & Rasmussen, S. A. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.1.102 · Cited by 705 · see citing works
A self‐report Insight Scale for psychosis: reliability, validity and sensitivity to change
Birchwood, M. J., Smith, J., Drury, V., Healy, J., Macmillan, F., & Slade, M. (1994) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1994.tb01487.x · Cited by 676 · see citing works
Violence and Severe Mental Illness: The Effects of Substance Abuse and Nonadherence to Medication
Swartz, M. S., Swanson, J. W., Hiday, V. A., Borum, R., Wagner, H. R., & Burns, B. J. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.2.226 · Cited by 628 · see citing works
Bellack, A. S. (2005) · Schizophrenia Bulletin · doi:10.1093/schbul/sbj044 · Cited by 573 · see citing works
Insight in schizophrenia: a meta-analysis
Mintz, A. R., Dobson, K. S., & Romney, D. M. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00316-x · Cited by 563 · see citing works
Awareness of Illness in Schizophrenia
AMADOR, X. F., Strauss, D. H., Yale, S. A., & Gorman, J. M. (1991) · Schizophrenia Bulletin · doi:10.1093/schbul/17.1.113 · Cited by 544 · see citing works
Interventions to Improve Medication Adherence in Schizophrenia
Zygmunt, A., Olfson, M., Boyer, C. A., & Mechanic, D. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.10.1653 · Cited by 541 · see citing works
Wallace, C., Mullen, P. E., & Burgess, P. M. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.4.716 · Cited by 537 · see citing works
Insight in Schizophrenia. Its Relationship to Acute Psychopathology
McEvoy, J. P., Apperson, L. J., Appelbaum, P. S., Ortlip, P., Brecosky, J., Hammill, K., Geller, J. L., & Roth, L. H. (1989) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198901000-00007 · Cited by 528 · see citing works
Medication adherence of individuals with a first episode of psychosis
Coldham, E. L., Addington, J., & Addington, D. E. (2002) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2002.02437.x · Cited by 415 · see citing works
Cognitive Behaviour Therapy for Psychosis: Theory and Practice
Fowler, D., Garety, P. A., & Kuipers, L. (1999) · Medical Entomology and Zoology · Cited by 384 · see citing works
Attitudes Toward Antipsychotic Medication
Day, J. C., Bentall, R. P., Roberts, C., Randall, F., Rogers, A. E., Cattell, D., Healy, D., Rae, P., & Power, C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.7.717 · Cited by 360 · see citing works
The Assessment of Insight in Psychosis
David, A. S., Buchanan, A. W., Reed, A., & Almeida, O. P. (1992) · The British Journal of Psychiatry · doi:10.1192/bjp.161.5.599 · Cited by 358 · see citing works
Postpsychotic Depression in Schizophrenia
McGlashan, T. H. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770020065011 · Cited by 347 · see citing works
A Meta-Analysis of the Effectiveness of Mental Health Case Management Over 20 Years
Ziguras, S. J., & Stuart, G. W. (2000) · Psychiatric Services · doi:10.1176/appi.ps.51.11.1410 · Cited by 335 · see citing works
Birchwood, M., Iqbal, Z., Chadwick, P., & Trower, P. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.6.516 · Cited by 315 · see citing works
A two-year prospective study of treatment compliance in patients with schizophrenia
Buchanan, A. W. (1992) · Psychological Medicine · doi:10.1017/s0033291700038228 · Cited by 287 · see citing works
Sanz, M. A. G., CONSTABLE, G., Lopez-Ibor, I., KEMP, R., & David, A. S. (1998) · Psychological Medicine · doi:10.1017/s0033291797006296 · Cited by 264 · see citing works
Insight and the Clinical Outcome of Schizopheric Patients
McEvoy, J. P., Freter, S. H., EVERETT, G., Geller, J. L., Appelbaum, P. S., Apperson, L. J., & Roth, L. H. (1989) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198901000-00008 · Cited by 253 · see citing works
Wiersma, D., WANDERLING, J. A., Dragomirecká, E., GANEV, K., Harrison, G. L., der Heiden, W. A., Nienhuis, F. J., & Walsh, D. (2000) · Psychological Medicine · doi:10.1017/s0033291799002627 · Cited by 251 · see citing works
Kim, C., Jayathilake, K., & Meltzer, H. Y. (2002) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00310-9 · Cited by 243 · see citing works
Pini, S., Cassano, G. B., Dell’Osso, L., & AMADOR, X. F. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.1.122 · Cited by 228 · see citing works
Iqbal, Z., Birchwood, M., Chadwick, P., & Trower, P. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.6.522 · Cited by 226 · see citing works
Violence in Inpatients With Schizophrenia: A Prospective Study
Arango, C., Barba, A. C., González-Salvador, T., et al. (1999) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a033396 · Cited by 216 · see citing works
Suicidal behavior in schizophrenia and its relationship to awareness of illness
AMADOR, X. F., Friedman, J. H., Kasapis, C., Yale, S. A., Flaum, M., & Gorman, J. M. (1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.9.1185 · Cited by 210 · see citing works
Predicting engagement with services for psychosis: insight, symptoms and recovery style
Tait, L., Birchwood, M. J., & Trower, P. (2003) · The British Journal of Psychiatry · doi:10.1192/bjp.182.2.123 · Cited by 207 · see citing works
The evolution of insight, paranoia and depression during early schizophrenia
DRAKE, R. J., PICKLES, A., BENTALL, R. P., KINDERMAN, P., HADDOCK, G., TARRIER, N., & LEWIS, S. W. (2004) · Psychological Medicine · doi:10.1017/s0033291703008821 · Cited by 204 · see citing works
Smith, T. E., Hull, J. W., Goodman, M. S., Hedayat-Harris, A., Willson, D. F., ISRAEL, L. M., & Munich, R. L. (1999) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199902000-00006 · Cited by 203 · see citing works
Violence in schizophrenia: role of hallucinations and delusions
Cheung, P., Schweitzer, I., Crowley, K., & Tuckwell, V. (1997) · Schizophrenia Research · doi:10.1016/s0920-9964(97)00049-2 · Cited by 197 · see citing works
Lack of Insight in Schizophrenia
Cuesta, M. J., & Peralta, V. (1994) · Schizophrenia Bulletin · doi:10.1093/schbul/20.2.359 · Cited by 195 · see citing works
Crumlish, N., Whitty, P., Kamali, M., Clarke, M., Browne, S., McTigue, O., Lane, A., Kinsella, A., Larkin, C., & O’Callaghan, E. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00620.x · Cited by 190 · see citing works
Awareness of Illness in Schizophrenia and Outpatient Treatment Adherence
Cuffel, B. J., ALFORD, J., Fischer, E. P., & Owen, R. R. (1996) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199611000-00001 · Cited by 169 · see citing works
Psychoeducation and Compliance in the Treatment of Schizophrenia
Pitschel‐Walz, G., Bäuml, J., Bender, W., Engel, R. R., Wagner, M., & Kissling, W. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0316 · Cited by 150 · see citing works
Sim, K., Mahendran, R., Siris, S. G., Heckers, S., & Chong, S. A. (2004) · Psychiatry Research · doi:10.1016/j.psychres.2004.07.007 · Cited by 149 · see citing works
Insight and Its Relationship to Violent Behavior in Patients With Schizophrenia
Buckley, P. F., Hrouda, D. R., Friedman, L., Noffsinger, S., Resnick, P. J., & Camlin-Shingler, K. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.9.1712 · Cited by 145 · see citing works
Marks, K. A., Fastenau, P. S., Lysaker, P. H., & Bond, G. R. (2000) · Schizophrenia Research · doi:10.1016/s0920-9964(99)00208-x · Cited by 144 · see citing works
The assessment of insight in clinical psychiatry: a new scale
Marková, I. S., & Berrios, G. E. (1992) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1992.tb03245.x · Cited by 143 · see citing works
Lack of insight among outpatients with schizophrenia
Dickerson, F., Boronow, J. J., Ringel, N., & Parente, F. J. (1997) · Psychiatric Services · doi:10.1176/ps.48.2.195 · Cited by 143 · see citing works
Correlates of insight and insight change in schizophrenia
Carroll, A., Fattah, S., Clyde, Z., Coffey, I., Owens, D. G. C., & Johnstone, E. C. (1999) · Schizophrenia Research · doi:10.1016/s0920-9964(98)00142-x · Cited by 142 · see citing works
Das AMDP-System : Manual zur Dokumentation psychiatrischer Befunde
Amdp (2007) · Cited by 137 · see citing works
Clinical correlates of early medication adherence: West London first episode schizophrenia study
Mutsatsa, S., Joyce, E. M., Hutton, S. B., Webb, E., Gibbins, H., Paul, S., & Barnes, T. R. E. (2003) · Acta Psychiatrica Scandinavica · doi:10.1046/j.0001-690x.2003.00193.x · Cited by 131 · see citing works
Foley, S. R., Kelly, B. D., Clarke, M., et al. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.03.010 · Cited by 130 · see citing works
Bourgeois, M. L., Swendsen, J. D., Young, F. K., AMADOR, X. F., Pini, S., Cassano, G. B., Lindenmayer, J., Hsu, C., Alphs, L. D., Meltzer, H. Y., et al. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.8.1494 · Cited by 129 · see citing works
Unawareness of illness and its relationship with depression and self-deception in schizophrenia
Moore, O., Cassidy, E., Carr, A., & O’Callaghan, E. (1999) · European Psychiatry · doi:10.1016/s0924-9338(99)00172-8 · Cited by 128 · see citing works
Measuring cognitive insight in middle-aged and older patients with psychotic disorders
Pedrelli, P., McQuaid, J. R., Granholm, E. L., Patterson, T. L., McClure, F. S., Beck, A. T., & Jeste, D. V. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.02.019 · Cited by 125 · see citing works
Does insight affect long-term inpatient treatment outcome in chronic schizophrenia?
Schwartz, R. C., Cohen, B. N., & Grubaugh, A. L. (1997) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(97)90061-4 · Cited by 122 · see citing works
INSIGHT AND WORK PERFORMANCE IN SCHIZOPHRENIA
Lysaker, P. H., BRYSON, G. J., & Bell, M. D. (2002) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200203000-00002 · Cited by 121 · see citing works
A prospective evaluation of adherence to medication in first episode schizophrenia
Kamali, M., Kelly, B. D., Clarke, M., Browne, S., Gervin, M., Kinsella, A., Lane, A., Larkin, C., & O’Callaghan, E. (2006) · European Psychiatry · doi:10.1016/j.eurpsy.2005.05.015 · Cited by 119 · see citing works
Donohoe, G. J., Owens, N., O’Donnell, C. P., Burke, T., Moore, L., Tobin, A., & O’Callaghan, E. (2001) · European Psychiatry · doi:10.1016/s0924-9338(01)00581-8 · Cited by 118 · see citing works
Insight in schizophrenia and its relationship to psychopathology
Kemp, R., & Lambert, T. (1995) · Schizophrenia Research · doi:10.1016/0920-9964(95)00018-6 · Cited by 117 · see citing works
Yen, C., Chen, C., Ko, C., Yeh, M.-L., Yang, S., Yen, J., Huang, C., & Wu, C. (2005) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2005.01392.x · Cited by 117 · see citing works
The relationship between insight and symptoms in schizophrenia
Sevy, S. M., Nathanson, K., Visweswaraiah, H., & AMADOR, X. F. (2003) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2003.09.002 · Cited by 116 · see citing works
Insight in schizophrenia and mood disorders and its relation to psychopathology
Michalakeas, A., Skoutas, C., Charalambous, A., Peristeris, A., Marinos, V., Keramari, E., & Theologou, A. (1994) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1994.tb01554.x · Cited by 116 · see citing works
Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions
WATSON, P. W. B., Garety, P. A., Weinman, J. A., Dunn, G., Bebbington, P., Fowler, D. G., Freeman, D. H., & Kuipers, E. (2006) · Psychological Medicine · doi:10.1017/s0033291706007458 · Cited by 114 · see citing works
Insight and Psychosocial Treatment Compliance in Schizophrenia
Lysaker, P. H., Bell, M. D., Milstein, R., BRYSON, G. J., & Goulet, J. L. (1994) · Psychiatry · doi:10.1080/00332747.1994.11024695 · Cited by 111 · see citing works
Reappraising insight in psychosis
Cuesta, M. J., Peralta, V., & Zarzuela, A. (2000) · The British Journal of Psychiatry · doi:10.1192/bjp.177.3.233 · Cited by 111 · see citing works
Insight in early psychosis: a 1-year follow-up
Mintz, A. R., Addington, J., & Addington, D. E. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(03)00047-1 · Cited by 109 · see citing works
Novak-Grubic, V., & Tavčar, R. (2002) · European Psychiatry · doi:10.1016/s0924-9338(02)00645-4 · Cited by 106 · see citing works
Strand, S. J. M., Belfrage, H., Fransson, G., et al. (1999) · Legal and Criminological Psychology · doi:10.1348/135532599167798 · Cited by 106 · see citing works
Garavan, J., Browne, S., Gervin, M., Lane, A., Larkin, C., & O’Callaghan, E. (1998) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(98)90063-3 · Cited by 101 · see citing works
Insight and symptom change in schizophrenia and other disorders
Weiler, M. A., Fleisher, M. H., & McArthur-Campbell, D. (2000) · Schizophrenia Research · doi:10.1016/s0920-9964(99)00215-7 · Cited by 101 · see citing works
Bhanji, N. H., Chouinard, G., & Margolese, H. C. (2003) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(03)00109-3 · Cited by 99 · see citing works
The social context of insight in schizophrenia
White, R., Bebbington, P., Pearson, J., Johnson, S., & Ellis, D. P. (2000) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050271 · Cited by 97 · see citing works
Does attitude toward psychosis relate to outcome?
McGlashan, T. H., & Carpenter, W. T. (1981) · American Journal of Psychiatry · doi:10.1176/ajp.138.6.797 · Cited by 94 · see citing works
Yen, C., Yeh, M.-L., Chen, C., et al. (2002) · Comprehensive Psychiatry · doi:10.1053/comp.2002.35901 · Cited by 85 · see citing works
A Trial of Compliance Therapy in Outpatients With Schizophrenia or Schizoaffective Disorder
Byerly, M., Fisher, R., Carmody, T. J., & Rush, A. J. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0806 · Cited by 82 · see citing works
Arango, C., Bombín, I., González-Salvador, T., García‐Cabeza, I., & Bobes, J. (2005) · European Psychiatry · doi:10.1016/j.eurpsy.2005.07.006 · Cited by 82 · see citing works
Soskis, D. A., & Bowers, M. B. (1969) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-196912000-00001 · Cited by 82 · see citing works
Cognitive behaviour therapy for psychosis
Kuipers, E., & Bebbington, P. (2006) · Epidemiology and Psychiatric Sciences · doi:10.1017/s1121189x00002153 · Cited by 79 · see citing works
The Relationship Between Insight, Illness and Treatment Outcome in Schizophrenia
Schwartz, R. C. (1998) · Psychiatric Quarterly · doi:10.1023/a:1022141322657 · Cited by 77 · see citing works
Work Rehabilitation and Improvements in Insight in Schizophrenia
Lysaker, P. H., & Bell, M. D. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199502000-00007 · Cited by 76 · see citing works
Agarwal, M., Sharma, V. K., Kishore Kumar, K. V., & Lowe, D. (1998) · International Journal of Social Psychiatry · doi:10.1177/002076409804400202 · Cited by 76 · see citing works
Gharabawi, G. M., Lasser, R. A., Bossie, C. A., Zhu, Y., & AMADOR, X. F. (2006) · International Clinical Psychopharmacology · doi:10.1097/00004850-200607000-00006 · Cited by 75 · see citing works
Hope, Awareness of Illness, and Coping in Schizophrenia Spectrum Disorders
Lysaker, P. H., Campbell, K., & Johannesen, J. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000161689.96931.0f · Cited by 73 · see citing works
Grevatt, M., Thomas‐Peter, B. A., & Hughes, G. (2004) · Journal of Forensic Psychiatry and Psychology · doi:10.1080/1478994032000199095 · Cited by 70 · see citing works
Suicidality and psychosis: the predictive potential of symptomatology and insight into illness
Schwartz, R. C., & Smith, S. D. (2003) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(03)00088-8 · Cited by 70 · see citing works
Kamali, M., Kelly, L. S., Gervin, M., et al. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.2.161 · Cited by 69 · see citing works
Insight in Clinical Psychiatry
Marková, I. S., & Berríos, G. E. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199512000-00003 · Cited by 68 · see citing works
Insight in paranoid schizophrenia—Its relationship to psychopathology and premorbid adjustment
Dębowska, G., Grazwa, A., & Kucharska‐Pietura, K. (1998) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(98)90032-3 · Cited by 67 · see citing works
Young, D. A., Campbell, Z., Zakzanis, K. K., & Weinstein, E. (2002) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00378-x · Cited by 66 · see citing works
The relationship between symptoms and insight in schizophrenia: a longitudinal perspective
Smith, T. E., Hull, J. W., & dos Santos, L. S. (1998) · Schizophrenia Research · doi:10.1016/s0920-9964(98)00063-2 · Cited by 64 · see citing works
Effect of Patient and Family Insight on Compliance of Schizophrenic Patients
Smith, C. M., Barzman, D. H., & Pristach, C. A. (1997) · The Journal of Clinical Pharmacology · doi:10.1002/j.1552-4604.1997.tb04773.x · Cited by 63 · see citing works
Insight and Suicidality in Schizophrenia: A Replication Study
Schwartz, R. C. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200004000-00007 · Cited by 63 · see citing works
Insight and recovery from psychosis in chronic schizophrenia and schizoaffective disorder patients
Smith, T. E., Hull, J. W., Huppert, J. D., Silverstein, S. M., Anthony, D. T., & McClough, J. F. (2003) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(03)00091-8 · Cited by 61 · see citing works
Insight in schizophrenia: A review
Dam, J. (2006) · Nordic Journal of Psychiatry · doi:10.1080/08039480600600185 · Cited by 61 · see citing works
Insight About Psychosis Among Outpatients With Schizophrenia
McEvoy, J. P., Freter, S. H., Merritt, M., & Apperson, L. J. (1993) · Psychiatric Services · doi:10.1176/ps.44.9.883 · Cited by 60 · see citing works
Understanding and assessing insight
AMADOR, X. F., & Kronengold, H. (2004) · Oxford University Press eBooks · doi:10.1093/med/9780198525684.003.0001 · Cited by 58 · see citing works
McEvoy, J. P., Schooler, N. R., Friedman, E. R., et al. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.11.1649 · Cited by 58 · see citing works
The relationship between insight into psychosis and compliance with medications
McEvoy, J. P. (2004) · Oxford University Press eBooks · doi:10.1093/med/9780198525684.003.0015 · Cited by 58 · see citing works
Insight and Hopelessness in Forensic Patients with Schizophrenia
Carroll, A., Pantelis, C., & Harvey, C. A. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2004.01315.x · Cited by 57 · see citing works
Schwartz, R. C. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200106000-00010 · Cited by 54 · see citing works
Mourning, insight, and reduction of suicide risk in schizophrenia
Lewis, L. (2004) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.68.3.231.40405 · Cited by 53 · see citing works
Suicide and awareness of illness in schizophrenia: An overview
Pompili, M., Ruberto, A., Kotzalidis, G. D., Girardi, P., & Tatarelli, R. (2004) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.68.4.297.56643 · Cited by 52 · see citing works
The Relationship between Insight and Suicidality among Patients with Schizophrenia
Schwartz, R. C., & Petersen, S. (1999) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199906000-00007 · Cited by 49 · see citing works
Recovery and insight in schizophrenia
Jørgensen, P. F. (1995) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1995.tb09609.x · Cited by 47 · see citing works
Compliance and psychological reactance in schizophrenia
Moore, A., Sellwood, W., & Stirling, J. (2000) · British Journal of Clinical Psychology · doi:10.1348/014466500163293 · Cited by 46 · see citing works
Cognitive Therapy of Schizophrenia
Dickerson, F. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000188984.36913.e4 · Cited by 37 · see citing works
The relationship between insight and clinical factors for persons with schizophrenia
Baier, M., DeShay, E., Owens, K., et al. (2000) · Archives of Psychiatric Nursing · doi:10.1053/apnu.2000.19088 · Cited by 36 · see citing works
Bjørkly, S. K. (2006) · Aggression and Violent Behavior · doi:10.1016/j.avb.2006.01.006 · Cited by 36 · see citing works
Lack of Awareness and Nonadherence in Schizophrenia
Kozuki, Y., & Froelicher, E. S. (2003) · Western Journal of Nursing Research · doi:10.1177/0193945902238836 · Cited by 30 · see citing works
Insight in Relation to Psychosocial Adjustment in Schizophrenia
Simon, A. E., Berger, G. E., Giacomini, V., Ferrero, F., & Mohr, S. (2004) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000130137.85640.70 · Cited by 24 · see citing works
Chen, K. C., Chu, C. L., Yang, Y. K., Yeh, T. L., LEE, I. H., CHEN, P. S., & Lu, R. B. (2005) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2005.01433.x · Cited by 23 · see citing works
Characteristics of schizophrenic patients with a history of suicide attempt
Evren, C., & Evren, B. (2004) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651500410005658-1 · Cited by 20 · see citing works
Beliefs, feelings and insight of patients with schizophrenia about taking medication
Davidhizar, R. E. (1987) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.1987.tb01318.x · Cited by 19 · see citing works
Kaplan, G. B., Phillips, K. A., Vaccaro, A., et al. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2005.11.009 · Cited by 19 · see citing works
Awareness of illness and outcome in schizophrenia
Rossi, A., Arduini, L., Prosperini, P., Kalyvoka, A., Stratta, P., & Daneluzzo, E. (2000) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s004060070037 · Cited by 18 · see citing works
Drug refusal among schizophrenic patients treated in the community
MACPHERSON, B. J. R. (1997) · Journal of Mental Health · doi:10.1080/09638239718905 · Cited by 16 · see citing works
Insight and symptoms of psychosis: A prospective inpatient study
Chen, E. Y. H. (1998) · Schizophrenia Research · doi:10.1016/s0920-9964(97)88374-0 · Cited by 8 · see citing works
Insight and hopelessness in forensic patients with schizophrenia
Carroll, A., Pantelis, C., & Harvey, C. A. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.2004.01315.x · Cited by 5 · see citing works
FOLEY, S. (2004) · Schizophrenia Research · doi:10.1016/s0920-9964(04)00106-9 · Cited by 4 · see citing works
Improving insight and compliance: Predictions and consequences
David, A. S., Kemp, R., Kirov, G., et al. (1998) · Schizophrenia Research · doi:10.1016/s0920-9964(97)88375-2 · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 8
- Torrey EF. The relationship of insight to violent behaviour and stigma. In: Amador X, David A, eds. Insight and Psychosis. Awareness of Illness in Schizophrenia and Related Disorders. Oxford, England: University Press; 2004: 243-256.
- Wing JK, Cooper JE, Sartorius N. Measurement and classi- fication of psychiatric symptoms: an instruction manual for the PSE and catego programme. Cambridge, England: Cam- bridge University Press; 1974.
- Kamali M, Kelly L, Gervin M, Browne S, Larkin C, O'Callaghan E. Insight and comorbid substance misuse and medication compliance among patients with schizophre- nia. Psychiatr Serv. 2001;52:161-166.
- Day JC, Bentall R, Roberts C, et al. Attitudes toward anti- psychotic medication-the impact of clinical variables and relationships with health professionals. Arch Gen Psychiatry. 2005;62:717-724.
- McEvoy JP, Freter S, Everett G, et al. Insight and the clin- ical outcome of schizophrenic patients. J Nerv Ment Dis. 1989;177:48-51.
- Simon AE, Berger GE, Giacomini V, Ferrero F, Mohr S. In- sight in relation to psychosocial adjustment in schizophre- nia. J Nerv Ment Dis. 2004;192:442-445.
- Amador XF, Flaum MM, Andreasen NC, et al. Awareness of illness in schizophrenia and schizoaffective and mood dis- orders. Arch Gen Psychiatry. 1994;51:826-836.
- Strand S, Belfrage H, Fransson G, Levander S. Clinical and risk management factors in risk prediction of mentally disor- dered offenders-more important than historical data? Legal Criminol Psychol. 1999;4:67-76.
Cited by
Sorted by citations
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Sendt, K.-V., Tracy, D. K., & Bhattacharyya, S. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2014.11.002 · Cited by 245 · see citing works
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Moritz, S., Veckenstedt, R., Bohn, F., Hottenrott, B., Scheu, F., Randjbar, S., Aghotor, J., Köther, U., Woodward, T. S., Treszl, A., et al. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.10.007 · Cited by 146 · see citing works
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Ho, S. C., Jacob, S. A., & Tangiisuran, B. (2017) · PLOS ONE · doi:10.1371/journal.pone.0179290 · Cited by 129 · see citing works
Cognitive insight: a systematic review.
Van Camp, L. S. C., Sabbe, B. G. C., & Oldenburg, J. F. E. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.04.011 · Cited by 99 · see citing works
Schrank, B., Amering, M., Hay, A. G., Weber, M., & Sibitz, I. (2014) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796013000322 · Cited by 97 · see citing works
Belvederi Murri, M., Amore, M., Calcagno, P., Respino, M., Marozzi, V., Masotti, M., Bugliani, M., Innamorati, M., Pompili, M., Galderisi, S., et al. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw040 · Cited by 96 · see citing works
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Rumination, depressive symptoms and awareness of illness in schizophrenia.
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Pousa, E., Ochoa, S., Cobo, J., Nieto, L., Usall, J., Gonzalez, B., Garcia-Ribera, C., Pérez Solà, V., Ruiz, A.-I., Baños, I., et al. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.02.016 · Cited by 37 · see citing works
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Schennach, R., Meyer, S., Seemüller, F., Jäger, M., Schmauss, M., Laux, G., Pfeiffer, H., Naber, D., Schmidt, L. G., Gaebel, W., et al. (2012) · European Psychiatry · doi:10.1016/j.eurpsy.2012.01.001 · Cited by 32 · see citing works
Cuesta, M. J., Peralta, V., Campos, M. S., & Garcia-Jalon, E. (2011) · Schizophrenia Research · doi:10.1016/j.schres.2011.04.032 · Cited by 33 · see citing works
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Koren, D., Viksman, P., Giuliano, A. J., & Seidman, L. J. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.10.013 · Cited by 29 · see citing works
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López‐Moríñigo, J. D., Wiffen, B., O'Connor, J., Dutta, R., Di Forti, M., Murray, R. M., & David, A. S. (2014) · Early Intervention in Psychiatry · doi:10.1111/eip.12042 · Cited by 26 · see citing works
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Yanos, P. T., Vayshenker, B., Pleskach, P., & Mueser, K. T. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.04.016 · Cited by 14 · see citing works
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- Authors
- Lincoln, T. M., Lullmann, E., & Rief, W.
- Affiliations
- Philipps University of Marburg (DE)
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-10-27
- Volume
- 33
- Issue
- 6
- Pages
- 1324-1342
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC2779879
- OpenAlex
- W2127144089
- Cited by
- 486
- References
- 122
- Citations by year
- 2026: 18 · 2025: 20 · 2024: 16 · 2023: 17 · 2022: 20 · 2021: 25 · 2020: 23 · 2019: 33 · 2018: 31 · 2017: 29 · 2016: 30 · 2015: 31 · 2014: 37 · 2013: 37 · 2012: 38
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed Central (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
- lack of insight, schizophrenia
- MeSH terms
- Cognition Disorders, Depression, Humans, Neuropsychological Tests, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Time Factors
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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.
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