The “insight paradox” in schizophrenia: Magnitude, moderators and mediators of the association between insight and depression
Open accessAbstract
The so-called "insight paradox" posits that among patients with schizophrenia higher levels of insight are associated with increased levels of depression. Although different studies examined this issue, only few took in account potential confounders or factors that could influence this association. In a sample of clinically stable patients with schizophrenia, insight and depression were evaluated using the Scale to assess Unawareness of Mental Disorder and the Calgary Depression Scale for Schizophrenia. Other rating scales were used to assess the severity of psychotic symptoms, extrapyramidal symptoms, hopelessness, internalized stigma, self-esteem, and service engagement. Regression models were used to estimate the magnitude of the association between insight and depression while accounting for the role of confounders. Putative psychological and sociodemographic factors that could act as mediators and moderators were examined using the PROCESS macro. By accounting for the role of confounding factors, the strength of the association between insight into symptoms and depression increased from 13% to 25% explained covariance. Patients with lower socioeconomic status (F = 8.5, P = .04), more severe illness (F = 4.8, P = .03) and lower levels of service engagement (F = 4.7, P = .03) displayed the strongest association between insight and depression. Lastly, hopelessness, internalized stigma and perceived discrimination acted as significant mediators. The relationship between insight and depression should be considered a well established phenomenon among patients with schizophrenia: it seems stronger than previously reported especially among patients with lower socioeconomic status, severe illness and poor engagement with services. These findings may have relevant implications for the promotion of insight among patients with schizophrenia.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Depression and anxiety are associated with better insight.
“Although insight into mental illness and capacity to decide treatment are strongly associated, both depression and anxiety are also associated with better insight (Murri et al., 2016;Stefanopoulou et al., 2009), which has been referred to as the 'insight paradox'.”
From Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis (2024) · cites this paper as Murri et al., 2016
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(2013) · Cited by 44,563 · see citing works
Equivalence of the Mediation, Confounding and Suppression Effect
MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000) · Prevention Science · doi:10.1023/a:1026595011371 · Cited by 4,188 · see citing works
A depression rating scale for schizophrenics
Addington, D. E., Addington, J., & Schıssel, B. (1990) · Schizophrenia Research · doi:10.1016/0920-9964(90)90005-r · Cited by 1,270 · see citing works
Leucht, S., Kane, J., Kissling, W., Hamann, J., Etschel, E., & Engel, R. R. (2005) · Schizophrenia Research · doi:10.1016/j.schres.2005.04.008 · Cited by 1,230 · 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
Wallwork, R. S., Fortgang, R. G., Hashimoto, R., Weinberger, D. R., & Dickinson, D. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.01.031 · Cited by 843 · see citing works
Schizophrenia and suicide: Systematic review of risk factors
Hawton, K. E., Sutton, L., Haw, C., Sinclair, J., & Deeks, J. J. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.1.9 · Cited by 777 · see citing works
Lysaker, P. H., Roe, D., & Yanos, P. T. (2006) · Schizophrenia Bulletin · doi:10.1093/schbul/sbl016 · Cited by 688 · 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
Yanos, P. T., Roe, D., Markus, K. A., & Lysaker, P. H. (2008) · Psychiatric Services · doi:10.1176/appi.ps.59.12.1437 · Cited by 536 · see citing works
Lincoln, T. M., Lullmann, E., & Rief, W. (2006) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm002 · Cited by 486 · see citing works
Galderisi, S., Rossi, A., Rocca, P., Bertolino, A., Mucci, A., Bucci, P., Rucci, P., Gibertoni, D., Aguglia, E., Amore, M., et al. (2014) · World Psychiatry · doi:10.1002/wps.20167 · Cited by 464 · see citing works
Self-citationKreyenbuhl, J. A., Nossel, I. R., & Dixon, L. B. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp046 · Cited by 443 · see citing works
Depression in Schizophrenia: Perspective in the Era of “Atypical” Antipsychotic Agents
Siris, S. G. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.9.1379 · Cited by 425 · see citing works
Integrating Mediators and Moderators in Research Design
MacKinnon, D. P. (2011) · Research on Social Work Practice · doi:10.1177/1049731511414148 · Cited by 417 · see citing works
Yanos, P. T., Roe, D. J., Markus, K. A., et al. (2008) · Psychiatric Services · doi:10.1176/ps.2008.59.12.1437 · Cited by 373 · see citing works
Measuring Socioeconomic Status
Cirino, P. T., Chin, C. E., Sevcik, R. A., Wolf, M., Lovett, M. W., & Morris, R. D. (2002) · Assessment · doi:10.1177/10791102009002005 · Cited by 371 · 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
Insight and personal narratives of illness in schizophrenia
Lysaker, P. H., Clements, C. A., Plascak-Hallberg, C. D., Knipscheer, S. J., & Wright, D. E. (2002) · Psychiatry: Interpersonal and Biological Processes · doi:10.1521/psyc.65.3.197.20174 · Cited by 344 · see citing works
What is the impact of self-stigma? Loss of self-respect and the “why try” effect
Corrigan, P. W., Bink, A. B., Schmidt, A., Jones, N., & Rüsch, N. (2015) · Journal of Mental Health · doi:10.3109/09638237.2015.1021902 · Cited by 320 · see citing works
Staring, A., van der Gaag, M., van den Berge, M., Duivenvoorden, H., & Mulder, C. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.06.015 · Cited by 242 · see citing works
Socioeconomic Status, Structural and Functional Measures of Social Support, and Mortality
Stringhini, S., Berkman, L., Dugravot, A., Ferrie, J. E., Marmot, M., Kivimaki, M., & Singh-Manoux, A. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kwr461 · Cited by 206 · see citing works
Psychological pathways to depression in schizophrenia
Birchwood, M. J., Iqbal, Z., & Upthegrove, R. (2005) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-005-0588-4 · Cited by 184 · see citing works
Suicide risk in first episode psychosis: A selective review of the current literature
Pompili, M., Serafini, G., Innamorati, M., Lester, D., Shrivastava, A., Girardi, P., & Nordentoft, M. (2011) · Schizophrenia Research · doi:10.1016/j.schres.2011.03.008 · Cited by 182 · see citing works
Self-citationMurri, M. B., Guaglianone, A., Bugliani, M., Calcagno, P., Respino, M., Serafini, G., Innamorati, M., Pompili, M., & Amore, M. (2015) · Drugs in R&D · doi:10.1007/s40268-014-0078-0 · Cited by 175 · see citing works
Self-citationCavelti, M., Kvrgic, S., Beck, E., Rüsch, N., & Vauth, R. (2011) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2011.08.001 · Cited by 159 · see citing works
A systematic review of instruments to measure depressive symptoms in patients with schizophrenia
Lako, I. M., Bruggeman, R., Knegtering, H., Wiersma, D., Schoevers, R. A., Slooff, C. J., & Taxis, K. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.10.014 · Cited by 154 · see citing works
Self-disorders and Schizophrenia: A Phenomenological Reappraisal of Poor Insight and Noncompliance
Henriksen, M. G., & Parnas, J. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbt087 · Cited by 143 · see citing works
Mucci, A., Galderisi, S., Merlotti, E., Rossi, A., Rocca, P., Bucci, P., Piegari, G., Chieffi, M., Vignapiano, A., & Maj, M. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2015.01.014 · Cited by 142 · see citing works
Self-citationBelvederi Murri, M., Respino, M., Innamorati, M., Cervetti, A., Calcagno, P., Pompili, M., Lamis, D. A., Ghio, L., & Amore, M. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.01.003 · Cited by 142 · see citing works
Self-citationA Meta-Analysis of Autobiographical Memory Studies in Schizophrenia Spectrum Disorder
Berna, F. S., Potheegadoo, J., Aouadi, I., Ricarte, J. J., Allé, M., Coutelle, R., Boyer, L., Cuervo-Lombard, C.-V., & Danion, J. (2015) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv099 · Cited by 136 · see citing works
Lysaker, P. H., Vohs, J., Hillis, J. D., Kukla, M., Popolo, R., Salvatore, G., & Dimaggio, G. (2013) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2013.811150 · Cited by 124 · see citing works
Parellada, M., Boada, L., Fraguas, D., Reig, S., Castro‐Fornieles, J., Moreno, D. M., González-Pinto, A. M., Otero, S., Rapado‐Castro, M., Graell, M., et al. (2010) · Schizophrenia Bulletin · doi:10.1093/schbul/sbq109 · Cited by 111 · see citing works
Changes in insight during treatment for psychotic disorders: A meta-analysis
Pijnenborg, G. H. M., van Donkersgoed, R. J. M., David, A. S., & Aleman, A. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2012.11.018 · Cited by 106 · 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
Hillis, J. D., Leonhardt, B. L., Vohs, J. L., Buck, K. D., Salvatore, G., Popolo, R., Dimaggio, G., & Lysaker, P. H. (2014) · Journal of Clinical Psychology · doi:10.1002/jclp.22148 · Cited by 97 · see citing works
Domains of Awareness in Schizophrenia
Gilleen, J., Greenwood, K., & David, A. S. (2010) · Schizophrenia Bulletin · doi:10.1093/schbul/sbq100 · Cited by 91 · see citing works
Correlates, change and ‘state or trait’ properties of insight in schizophrenia
Wiffen, B. D. R., Rabinowitz, J., Lex, A., & David, A. S. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.03.005 · Cited by 88 · see citing works
Subjective experience and mental side‐effects of antipsychotic treatment
Gerlach, J., & Larsen, E. B. (1999) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1999.tb05990.x · Cited by 84 · see citing works
Insight in schizophrenia and risk of suicide: a systematic update
López-Moríñigo, J.-D., Ramos‐Ríos, R., David, A. S., & Dutta, R. (2011) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2011.05.015 · Cited by 80 · see citing works
Lysaker, P. H., Vohs, J., Hasson‐Ohayon, I., Kukla, M., Wierwille, J. L., & Dimaggio, G. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.05.025 · Cited by 80 · see citing works
Depression in first episode psychosis: The role of subordination and shame
Upthegrove, R., Ross, K., Brunet, K., McCollum, R., & Jones, L. A. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.03.023 · Cited by 75 · see citing works
Hausmann, A., & Fleischhacker, W. W. (2002) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2002.02120.x · Cited by 75 · see citing works
Sandhu, A., Ives, J., Birchwood, M. J., & Upthegrove, R. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.01.018 · Cited by 74 · see citing works
Zuckerman, K. E., Lindly, O. J., Sinche, B., & Nicolaidis, C. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000136 · Cited by 72 · see citing works
Neurobiological underpinnings of insight deficits in schizophrenia
Shad, M. U., Keshavan, M. S., Tamminga, C. A., Cullum, C. M., & David, A. S. (2007) · International Review of Psychiatry · doi:10.1080/09540260701486324 · Cited by 69 · see citing works
The effects of aging on insight into illness in schizophrenia: a review
Gerretsen, P., Plitman, E., Rajji, T. K., & Graff‐Guerrero, A. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4154 · Cited by 68 · see citing works
Roohafza, H., Sadeghi, M., Shirani, S., Bahonar, A., Mackie, M., & Sarrafzadegan, N. (2009) · Croatian Medical Journal · doi:10.3325/cmj.2009.50.380 · Cited by 65 · see citing works
Assessment of Trait and State Aspects of Depression in Schizophrenia
Chiappelli, J., Nugent, K. L., Thangavelu, K., Searcy, K., & Hong, L. E. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbt069 · Cited by 59 · see citing works
Freudenreich, O., Deckersbach, T., & GOFF, D. C. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00319.x · Cited by 55 · see citing works
Cavelti, M., Beck, E., Kvrgic, S., Kossowsky, J., & Vauth, R. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.20872 · Cited by 55 · see citing works
Suicidal Behavior in Schizophrenia
Restifo, K., Harkavy‐Friedman, J., & Shrout, P. E. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318199f452 · Cited by 53 · see citing works
Sociodemographic Characteristics, Health Beliefs, and the Accuracy of Cancer Knowledge
Wilkinson, A. V., Vasudevan, V., Honn, S. E., Spitz, M. R., & Chamberlain, R. M. (2009) · Journal of Cancer Education · doi:10.1080/08858190802664834 · Cited by 52 · see citing works
Insight and suicidal behavior in first-episode schizophrenia
Melle, I. S., & Barrett, E. A. (2012) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.191 · Cited by 44 · see citing works
Does socioeconomic status predict course and outcome in patients with psychosis?
Samele, C., van Os, J., McKenzie, K. J., Wright, A. J., Gilvarry, C. M., Manley, C., Tattan, T., & Murray, R. M. (2001) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s127-001-8196-3 · Cited by 39 · see citing works
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
The Relationships Among Insight, Social Support, and Depression in Psychosis
Kaiser, S. L., Snyder, J. A., Corcoran, R., & Drake, R. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000242975.96932.4c · Cited by 25 · see citing works
Trotman, H. D., Kirkpatrick, B. W., & Compton, M. T. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.08.024 · Cited by 24 · see citing works
Dumas, R., Baumstarck, K., Michel, P., Lançon, C., Auquier, P., & Boyer, L. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0361-8 · Cited by 21 · see citing works
Hwang, S. S., Chang, J. S., Lee, K. Y., Kim, S. H., Ahn, Y. M., & Kim, Y. S. (2009) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e32832d6bca · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Cirino PT, Chin CE, Sevcik RA, et al. Measuring socioeco- nomic status: reliability and preliminary validity for different approaches. Assessment. 2002;9:145-155.
Cited by
Sorted by citations
Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018) · World Psychiatry · doi:10.1002/wps.20508 · Cited by 247 · see citing works
The impact of illness identity on recovery from severe mental illness: A review of the evidence
Yanos, P. T., DeLuca, J. S., Roe, D., & Lysaker, P. H. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112950 · Cited by 162 · see citing works
Comorbid Major Depressive Disorder in Schizophrenia: A Systematic Review and Meta-Analysis
Etchecopar‐Etchart, D., Korchia, T., Loundou, A., Llorca, P., Auquier, P., Lançon, C., Boyer, L., & Fond, G. B. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa153 · Cited by 114 · see citing works
The Multiple Dimensions of Insight in Schizophrenia-Spectrum Disorders
Murri, M. B., & Amore, M. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sby092 · Cited by 87 · see citing works
Self-citationHarvey, P. D., Twamley, E. W., Pinkham, A. E., Depp, C. A., & Patterson, T. L. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw103 · Cited by 79 · see citing works
Barlati, S., Morena, D., Nibbio, G., Cacciani, P., Corsini, P., Mosca, A., Deste, G., Accardo, V., Turrina, C., Valsecchi, P., et al. (2021) · Schizophrenia Research · doi:10.1016/j.schres.2021.06.007 · Cited by 67 · see citing works
Rossi, A., Amore, M., Galderisi, S., Rocca, P., Bertolino, A., Aguglia, E., Amodeo, G., Bellomo, A., Bucci, P., Buzzanca, A., et al. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.04.040 · Cited by 59 · see citing works
Self-citationLarkin, A., & Hutton, P. (2017) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.116.193458 · Cited by 57 · see citing works
Pellet, J., Golay, P., Nguyen, A., Suter, C., Ismailaj, A., Bonsack, C., & Favrod, J. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.03.022 · Cited by 56 · see citing works
Amore, M., Murri, M. B., Calcagno, P., Rocca, P., Rossi, A., Aguglia, E., Bellomo, A., Blasi, G., Carpiniello, B., Cuomo, A., et al. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2020.45 · Cited by 51 · see citing works
Self-citationMervis, J., Vohs, J. L., & Lysaker, P. H. (2022) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2022.2049757 · Cited by 37 · see citing works
Differences in theory of mind between early and chronic stages in schizophrenia
Fernandez, L. G., Cabot-Ivorra, N., Romero‐Ferreiro, V., Pérez-Martín, J., & Rodríguez–Jiménez, R. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.05.009 · Cited by 35 · see citing works
Lysaker, P. H., Weiden, P. J., Sun, X., O’Sullivan, A. K., & McEvoy, J. P. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04190-w · Cited by 36 · see citing works
Changes in insight over the first 24 months of treatment in schizophrenia spectrum disorders
Phahladira, L. S., Asmal, L., Kilian, S., Chiliza, B., Scheffler, F., Luckhoff, H. K., du Plessis, S., & Emsley, R. A. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.10.013 · Cited by 34 · see citing works
Ayesa‐Arriola, R., Pelayo‐Terán, J. M., López-Moríñigo, J.-D., Canal‐Rivero, M., Setién‐Suero, E., Al‐Halabí, S., Cuesta, M. J., David, A. S., & Crespo‐Facorro, B. (2018) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2018.05.005 · Cited by 32 · see citing works
Association between perceived social support and recovery among patients with schizophrenia
El‐Monshed, A. H., & Amr, M. (2020) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2020.100236 · Cited by 31 · see citing works
Accuracy of self-assessment of real-life functioning in schizophrenia
Rocca, P., Brasso, C., Montemagni, C., Bellino, S., Rossi, A., Bertolino, A., Gibertoni, D., Aguglia, E., Amore, M., Andriola, I., et al. (2021) · Schizophrenia · doi:10.1038/s41537-021-00140-9 · Cited by 30 · see citing works
Self-citationSelf-Awareness Deficits of Cognitive Impairment in Individuals With Schizophrenia. Really?
Raffard, S., Lebrun, C., Bayard, S., Macgregor, A., & Capdevielle, D. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00731 · Cited by 26 · see citing works
Konsztowicz, S., & Lepage, M. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.11.001 · Cited by 26 · see citing works
Nkire, N., Scully, P. J., Browne, D. J., Baldwin, P. A., Kingston, T., Owoeye, O., Kinsella, A., O’Callaghan, E., Russell, V., & Waddington, J. L. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.03.003 · Cited by 25 · see citing works
Yin, Y., Tong, J., Huang, J., Tian, B., Chen, S., Tan, S., Wang, Z., Yang, F., Tong, Y., Fan, F., et al. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2021.1993399 · Cited by 23 · see citing works
Adherence, insight and disability in paranoid schizophrenia
García‐Cabeza, I., Díaz‐Caneja, C. M., Bruna, M. M. O., & Portugal, E. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.09.021 · Cited by 21 · see citing works
Komatsu, H., Ono, T., Maita, Y., Ishida, Y., Kikuchi, T., Maki, T., Hase, S., Sakurai, H., Oba, A., Teshirogi, O., et al. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s280485 · Cited by 21 · see citing works
Béland, S., & Lepage, M. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.082 · Cited by 19 · see citing works
Marcó-García, S., Ariyo, K., Owen, G. S., & David, A. S. (2024) · Psychological Medicine · doi:10.1017/s0033291724000242 · Cited by 18 · see citing works
Skar-Fröding, R., Clausen, H. K., Benth, J. Š., Ruud, T., Slade, M., & Heiervang, K. S. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03691-y · Cited by 18 · see citing works
Murri, M. B., Bertelli, R., Carozza, P., Berardi, L., Cantarelli, L., Croce, E., Antenora, F., Curtarello, E. M. A., Simonelli, G., Recla, E., et al. (2020) · Early Intervention in Psychiatry · doi:10.1111/eip.13095 · Cited by 18 · see citing works
Gan, J., He, J., Fu, H. C., & Zhu, X. (2021) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2021.2013532 · Cited by 16 · see citing works
Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies
Li, W., Zhang, H.-H., Wang, Y., Zhang, L., Ungvari, G. S., Cheung, T. C. C., & Xiang, Y. (2020) · Psychiatric Quarterly · doi:10.1007/s11126-020-09786-7 · Cited by 15 · see citing works
The association of clinical insight and depression with quality of life in schizophrenia
Arrarás, J. I., Ibáñez, B., Pereda, N., Iribarren, S., & Basterra, I. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.02.069 · Cited by 15 · see citing works
Blay, M., Adam, O., Bation, R., Galvão, F., Brunelin, J., & Mondino, M. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm11010040 · Cited by 14 · see citing works
Schandrin, A., Norton, J. L., Raffard, S., Aouizerate, B., Berna, F. S., Brunel, L., Chéreau, I., d’Amato, T., Denizot, H., Dubertret, C., et al. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.07.029 · Cited by 13 · see citing works
Phahladira, L. S., Asmal, L., Luckhoff, H. K., du Plessis, S. S., Scheffler, F., Kilian, S., Smit, R., Buckle, C., Chiliza, B., & Emsley, R. A. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113767 · Cited by 13 · see citing works
Is too much insight bad for you?
López-Moríñigo, J.-D., & David, A. S. (2024) · The British Journal of Psychiatry · doi:10.1192/bjp.2024.173 · Cited by 12 · see citing works
Hardman, J. R., Gleeson, J., González‐Blanch, C., Álvarez‐Jiménez, M., Fraser, M. I., & Yap, K. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2881 · Cited by 11 · see citing works
Associations Between Clinical Insight and History of Severe Violence in Patients With Psychosis
Fischer-Vieler, T., Ringen, P. A., Kvig, E. I., Bell, C., Hjell, G., Tesli, N., Rokicki, J., Melle, I. S., Andreassen, O. A., Friestad, C., et al. (2023) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgad011 · Cited by 10 · see citing works
Rate and correlates of self-stigma in adult patients with early psychosis
Chu, R. S. T., Ng, C. M., Chu, S. C., Lui, T. T., Lau, F. C., Chan, S. K. W., Lee, E. H. M., Hui, C. L. M., Chen, E. Y. H., Lui, S. S. Y., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1200568 · Cited by 10 · see citing works
Meiseberg, J., & Moritz, S. (2020) · Schizophrenia Research · doi:10.1016/j.schres.2020.03.050 · Cited by 10 · see citing works
Symptomatic Predictors of Suicidal Behavior in Early Psychosis: Systematic Review
Ricci, V., Sarni, A., Berardis, D. D., Fraccalini, T., Martinotti, G., & Maina, G. (2025) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000860 · Cited by 10 · see citing works
Cobo, J., Labad, J., Pousa, E., Nieto, L. L., Ochoa, S., Usall, J., García-Ribera, C., Baños, I., González, B., Massons, C., et al. (2020) · Archives of Women s Mental Health · doi:10.1007/s00737-020-01031-1 · Cited by 9 · see citing works
Mervis, J., Bonfils, K. A., Cooper, S. E., Wiesepape, C. N., & Lysaker, P. H. (2021) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgab034 · Cited by 9 · see citing works
Cognitive insight and introspective accuracy in individuals with bipolar disorder: A scoping review
Wels, L., Dalkner, N., Lenger, M., Fellendorf, F. T., Schönthaler, E. M. D., Harvey, P. D., & Reininghaus, E. Z. (2023) · Neuroscience Applied · doi:10.1016/j.nsa.2023.101132 · Cited by 8 · see citing works
Insight in psychosis: A critical review of the contemporary confusion
Jacob, K. (2019) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2019.101921 · Cited by 8 · see citing works
Gan, J., Liu, W., Fan, J., Yi, J., Tan, C., & Zhu, X. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.09.074 · Cited by 8 · see citing works
Gardsjord, E. S., Romm, K. L., Røssberg, J. I., Friis, S., Barder, H. E., Evensen, J. H., Haahr, U., Hegelstad, W. T. V., Joa, I., Johannessen, J. O., et al. (2018) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2018.07.014 · Cited by 7 · see citing works
Santarelli, V., Marucci, C., Collazzoni, A., Rossetti, M. C., Pizziconi, G., Pacitti, F., Stratta, P., Rossi, A., & Rossi, R. (2019) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-019-01082-1 · Cited by 8 · see citing works
Insight Into Illness and Defense Styles in Schizophrenia
Ogawa, Y., Fukuhara, K., Tanaka, H., Nagata, Y., Ishimaru, D., & Nishikawa, T. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001038 · Cited by 6 · see citing works
Psychopathology and Poor Clinical Insight in Psychotic Patients
Habibi, M., Hosseini, S. R., Yegaei, P. S., Moradi, S., & Lysaker, P. H. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001475 · Cited by 6 · see citing works
Are delusions pathological beliefs?
Bortolotti, L. (2022) · Asian Journal of Philosophy · doi:10.1007/s44204-022-00033-3 · Cited by 6 · see citing works
Galliot, G., Sánchez-Rodríguez, R., Belloc, A., Phulpin, H., Icher, A., Birmes, P. J., Faure, K., & Gozé, T. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114726 · Cited by 6 · see citing works
Liu, X., Wang, D., Wang, D., Fan, R., Rong-ke, W., Xiang, H., Liu, J., & Liu, Y. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115108 · Cited by 6 · see citing works
Stabell, L. A., Gjestad, R., Kroken, R. A., Løberg, E., Jørgensen, H. A., & Johnsen, E. (2019) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2019.1636134 · Cited by 6 · see citing works
Why using “consciousness” in psychotherapy? Insight, metacognition and self-consciousness
Martin, S. S. (2023) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2023.101015 · Cited by 8 · see citing works
Çallı, S. Y., Fidan, Y. S., Beştepe, E. E., & İzci, F. (2023) · Psychiatry and Clinical Psychopharmacology · doi:10.5152/pcp.2023.22530 · Cited by 5 · see citing works
Quality of life and its influencing factors in patients with schizophrenia.
Lin, C., Wan, X., Zhang, R., Yang, X., & Liu, Y. (2023) · PubMed Central · doi:10.11817/j.issn.1672-7347.2023.220438 · Cited by 5 · see citing works
Barbalat, G., Maréchal, L., Plasse, J., Chéreau, I., Gouache, B., Legros-Lafarge, É., Massoubre, C., Guillard-Bouhet, N., Haesebaert, F., & Nicolas Franck, B. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.12.015 · Cited by 5 · see citing works
Murri, M. B., Folesani, F., Nanni, M. G., & Grassi, L. G. (2024) · Springer eBooks · doi:10.1007/978-3-031-68881-2_3 · Cited by 5 · see citing works
Insight is a useful construct in clinical assessments if used wisely
David, A. S., & Ariyo, K. (2020) · Journal of Medical Ethics · doi:10.1136/medethics-2020-106128 · Cited by 5 · see citing works
Bouvet, C., Naudin, C., & Zajac, J. (2019) · L Encéphale · doi:10.1016/j.encep.2018.12.004 · Cited by 5 · see citing works
Cognitive therapies and insight in early schizophrenia: A systematic review
Houdebine, B., Rondeau, N., & Besche‐Richard, C. (2025) · L Encéphale · doi:10.1016/j.encep.2025.05.009 · Cited by 4 · see citing works
Clinical and psychological correlates of insight dimensions in patients with early psychosis
Kam, T. K., Lui, T. T., Lau, F. C., Chan, S. K. W., Lee, E. H. M., Hui, C. L. M., Suen, Y. N., Lui, S. S. Y., Chen, E. Y. H., & Chang, W. C. (2021) · Early Intervention in Psychiatry · doi:10.1111/eip.13191 · Cited by 4 · see citing works
Koçak, M. B., & Atkaya, N. Ö. (2024) · Psychiatry and Clinical Psychopharmacology · doi:10.5152/pcp.2024.23787 · Cited by 4 · see citing works
Atapattu, M., Gonzales, H. M., & Williams, N. (2022) · Journal of Psychosocial Rehabilitation and Mental Health · doi:10.1007/s40737-022-00274-8 · Cited by 4 · see citing works
Stip, E., Al-Mugaddam, F., Nauman, J., Baki, A., & Potvin, S. (2022) · Schizophrenia Research: Cognition · doi:10.1016/j.scog.2022.100267 · Cited by 4 · see citing works
Kerkeni, A., Amorri, F., Abbes, W., Kolsi, S., Bouaziz, A., Medhaffar, K., & Zitoun, K. (2025) · Middle East Current Psychiatry · doi:10.1186/s43045-025-00582-2 · Cited by 3 · see citing works
Insight Paradox in Patients With Schizophrenia: A Concept Analysis
Mitsubayashi, R., & Sugaya, T. (2025) · International Journal of Mental Health Nursing · doi:10.1111/inm.70164 · Cited by 3 · see citing works
How do psychedelics impact people with a history of non-affective psychosis? A qualitative study
Dourron, H. M., Copes, H., Grossman, D. H., Bradley, M., Nicholas, C. R. N., Turner, J. A., Allen-Clark, G., Gossage, M., & Hendricks, P. S. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1716545 · Cited by 3 · see citing works
Park, S., Lee, N. Y., Jeong, H. Y., Chung, I., Kim, Y. S., & Jeong, S. H. (2024) · Psychiatry Investigation · doi:10.30773/pi.2023.0396 · Cited by 2 · see citing works
Mathew, R. S., & Nair, I. V. (2023) · Kerala Journal of Psychiatry · doi:10.30834/kjp.36.1.2023.364 · Cited by 2 · see citing works
Zhuo, C., Ji, F., Lin, X., Tian, H., Wang, L., Liu, S., Sang, H., Wang, W., & Chen, C. (2019) · Brain Imaging and Behavior · doi:10.1007/s11682-019-00207-3 · Cited by 2 · see citing works
Suicide and psychiatric disorders
Berardelli, I., Rogante, E., Lamis, D. A., & Pompili, M. (2024) · Oxford University Press eBooks · doi:10.1093/med/9780198843405.003.0018 · Cited by 2 · see citing works
Self-citationThe impact of socioeconomic factors on the incidence and characteristics of first-episode psychosis
Murri, M. B., Onofrio, A., Punzi, C., Caranci, N., Rubolino, E., Giovinazzi, F., Azzolina, D., Folesani, F., Grassi, L. G., Tarricone, I., et al. (2025) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796025100206 · Cited by 1 · see citing works
Colmenero-Capote, L., López‐Díaz, Á., Parás, C., Ayesa‐Arriola, R., & López-Moríñigo, J.-D. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.11.012 · Cited by 1 · see citing works
Does insight improve during the course of psychosis?
Seif, P., del Re, E. C., Tamminga, C. A., Pearlson, G. D., Clementz, B. A., McDowell, J., Ivleva, E. I., Hamada, K., Hill, S. K., Keedy, S., et al. (2025) · Schizophrenia Research · doi:10.1016/j.schres.2025.11.005 · Cited by 1 · see citing works
ПРОБЛЕМА СУИЦИДА ПРИ ШИЗОФРЕНИИ: В ФОКУСЕ ВНИМАНИЯ СЕМЬЯ БОЛЬНОГО (ОБЗОР ЛИТЕРАТУРЫ)
Simak, O. Y. (2018) · Суицидология · doi:10.32878/suiciderus.18-09-04(33)-17-28 · Cited by 1 · see citing works
Kim, J., Romero, L., Iwata, Y., Caravaggio, F., Remington, G. J., Graff‐Guerrero, A., Gerretsen, P., & Agid, O. (2022) · Annals of Clinical Psychiatry · doi:10.12788/acp.0081 · Cited by 1 · see citing works
The complex interplay between schizotypy and emotional, cognitive and psychological factors
Webster, L. (2019) · Nottingham Trent University's Institutional Repository (Nottingham Trent Repository)
Additional Commentary About the Interventions Aimed at Improving Insight
Ogawa, Y. (2020) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001186
Ogawa, Y., Fukuhara, K., Tanaka, H., Nagata, Y., Ishimaru, D., Urakawa, M., & Nishikawa, T. (2021) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001392
Baliga, S., Kedare, J. S., Mankar, U. J., & Kamath, R. M. (2021) · Indian Journal of Psychological Medicine · doi:10.1177/02537176211010504
EVALUATION OF SUICIDAL BEHAVIOR AND DEPRESSION, INSIGHT AND DISEASE CHARACTERISTICS IN SCHIZOPHRENIA
Çelik, F. G. H., Puşuroğlu, M., Baltacıoğlu, M., Bahçeci, B., & Hocaoğlu, Ç. (2024) · Akdeniz Medical Journal · doi:10.53394/akd.1286393
Rae, J., Lavigne, K. M., Sauvé, G., Lepage, M., & Raucher‐Chéné, D. (2025) · The Canadian Journal of Psychiatry · doi:10.1177/07067437251329074
Endres, R. J., Heinze, M., & Ignatyev, Y. (2025) · Mental Illness · doi:10.1155/mij/7975184
Chao, H.-C., Lo, S., Beckstead, J. W., & Yang, C. (2025) · Asian Nursing Research · doi:10.1016/j.anr.2025.10.004
Gawron, L., Portella, M. J., & Pousa, E. (2026) · Psychiatry Research · doi:10.1016/j.psychres.2026.116965
Biopsychosocial correlates of active suicidal ideation in obsessive-compulsive disorder
Huang, X., & Kuang, X. (2026) · Psychiatry Research · doi:10.1016/j.psychres.2026.117034
You, S., Xie, Y., Wang, X., Tang, S., & Wu, D. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1744418
Changes in insight and outcome over the early course of first-episode psychosis. The OPTiMiSE trial
López-Moríñigo, J.-D., Díaz‐Caneja, C. M., Galvañ, J., Fraguas, D., Moreno, C., Berger, G., Leucht, S., Rossum, I. W.-V., David, A. L., & Arango, C. (2026) · Schizophrenia Research Cognition · doi:10.1016/j.scog.2026.100441
Medication Adherence in Schizophrenia: Associations With Insight, Quality of Life, and Metacognition
Demirtaş, M., Yoldaş, S., & Demirel, Ö. F. (2026) · Annals of Clinical Psychiatry · doi:10.1177/10401237261473593
Mert, A., Çiftcioğlu, S., Soylu, E., Çiftçi, Z., & Soylu, M. F. (2026) · Australasian Psychiatry · doi:10.1177/10398562261476921
Insight in Psychosis and Suicidality: A Scoping Review of a Paradoxical Relationship
Gieselman, M., Wiesepape, C. N., & Garrelts, J. (2026) · Psychiatry International · doi:10.3390/psychiatryint7050206
Chen, X., & Yaowu, G. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1931821
Capell, E. F., González-Caballero, J. L., Cid, J., Romero-López-Alberca, C., Ochoa, S., Vila‐Badia, R., Salvador‐Carulla, L., & Moreno‐Küstner, B. (2026) · Schizophrenia Research Cognition · doi:10.1016/j.scog.2026.100465
- Authors
- Belvederi Murri, M., Amore, M., Calcagno, P., Respino, M., Marozzi, V., Masotti, M., Bugliani, M., Innamorati, M., Pompili, M., Galderisi, S., & Maj, M.
- Affiliations
- University of Genoa (IT)
- European University of Rome (IT)
- Azienda Ospedaliera Sant'Andrea (IT)
- ORCID
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-04-11
- Volume
- 42
- Issue
- 5
- Pages
- 1225-1233
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC4988746
- OpenAlex
- W2320969921
- Cited by
- 96
- References
- 59
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 8 · 2023: 10 · 2022: 10 · 2021: 11 · 2020: 14 · 2019: 11 · 2018: 8 · 2017: 3 · 2016: 1
- FWCI
- 6.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Schizophrenia Bulletin (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- 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 › Social Psychology › Mental Health Treatment and Access
- Keywords
- schizophrenia
- MeSH terms
- Adult, Awareness, Depression, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Schizophrenia, Schizophrenic Psychology, Self-Assessment, Self Concept, Severity of Illness Index, Social Class
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.
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 ›
Are you an author, or do you see a problem with this page? Request a review
