Cross-sectional and Longitudinal Relationships Between Insight and Attitudes Toward Medication and Clinical Outcomes in Chronic Schizophrenia
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BACKGROUND: We evaluated the cross-sectional and longitudinal association of measures of both insight and attitudes toward medication to outcomes that included psychopathology and community functioning. METHODS: Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) was a large 18-month follow-up study pharmacotherapy of people with schizophrenia. Insight was measured using the Insight and Treatment Attitudes Questionnaire and attitudes toward medication by the Drug Attitude Inventory. Widely known scales were used to assess symptoms of schizophrenia and depression and community functioning. Medication adherence was globally assessed by the treating psychiatrist using several sources of information. Bivariate correlations and mixed model regression analyses were used to test the relationship of insight and medication attitudes to outcomes at baseline and during the follow-up period. Regression models were used to evaluate the relationship between change in insight and medication attitudes and changes outcomes. RESULTS: There was a significant relationship at baseline between insight and drug attitudes and symptoms of schizophrenia and depression, as well as with community functioning. Higher levels of insight at baseline were significantly associated with lower levels of schizophrenia symptoms at follow-up while more positive medication attitudes were significantly associated with both lower symptom levels and better community functioning. Change in insight scores over time was associated with declining schizophrenia symptoms but increasing levels of depression. Change toward more positive medication attitudes was associated, independently of changes in insight, with significant decreases in psychopathology, improvement in community functioning, and greater medication compliance. CONCLUSION: Greater patient understanding of their illness and more positive attitudes toward medication may improve outcomes. Educational interventions that affect these attitudes may be an important part of psychosocial rehabilitation and/or recovery-oriented services.
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Patients having negative attitude towards their medication was a factor associated with psychotropic medication non-adherence in four studies.
“Patients having negative attitude towards their medication was a factor associated with psychotropic medication non-adherence [23, 25, 39, 65].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [39]
Lack of sufficient and quality health education to psychiatric patients and/or their caregivers/relatives/families about the medication and illness influenced patients' adherence to their prescribed medication.
“On the other hand, the lack of sufficient and quality health education to psychiatric patients and or their caregivers/relatives/families about the medication and illness influenced patients’ adherence to their prescribed medication [22, 36, 39, 40, 51].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [39]
Various social support-related factors (cohesiveness, family reminding, transport to hospital, lower family harmony, discrimination, disruption of family functioning, weak community functioning, homelessness, old age caregivers, lack of family compliance, lack of advice, not receiving social assistance, caregivers' attribution) were associated with psychotropic medication non-adherence.
“Cohesiveness, family reminding, and transport to hospital [37], lower family harmony or lack of resilient family support, discrimination by nearby people, disruption of family functioning or household routine and religious practices [45], weak community functioning [39], homelessness [42, 43], had old age caregivers or lack of caregivers [50], lack of family compliance of follow-up [51], lack of”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [39]
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Depression in schizophrenia: the influence of the different dimensions of insight
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Self-citationThe impact of insight on social functioning in patients with schizophrenia
Erol, A., Delibas, H., Bora, O., & Mete, L. (2015) · International Journal of Social Psychiatry · doi:10.1177/0020764014548287 · Cited by 44 · see citing works
Is Personal Recovery in Schizophrenia Predicted by Low Cognitive Insight?
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Insight and white matter fractional anisotropy in first-episode schizophrenia
Asmal, L., du Plessis, S., Vink, M., Fouche, J.-P., Chiliza, B., & Emsley, R. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2016.11.005 · Cited by 24 · see citing works
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- Authors
- Mohamed, S., Rosenheck, R., McEvoy, J., Swartz, M., Stroup, S., & Lieberman, J. A.
- Affiliations
- Yale University (US)
- Duke University (US)
- Columbia University (US)
- Corresponding author
- Mohamed, S.
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-06-26
- Volume
- 35
- Issue
- 2
- Pages
- 336-346
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC2659303
- OpenAlex
- W2115139068
- Cited by
- 258
- References
- 89
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 16 · 2021: 9 · 2020: 12 · 2019: 10 · 2018: 18 · 2017: 16 · 2016: 12 · 2015: 17 · 2014: 27 · 2013: 25 · 2012: 20
- FWCI
- 11.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- National Institutes of Health
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- insight, attitudes toward medication
- MeSH terms
- Adolescent, Adult, Aged, Attitude to Health, Awareness, Chronic Disease, Cognition Disorders, Cross-Sectional Studies, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Treatment Outcome, Medication Adherence
About these checks
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.
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