Relationship between cognitive insight and subjective quality of life in outpatients with schizophrenia
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BACKGROUND: The concept of cognitive insight refers to the cognitive processes involved in patients' re-evaluation of their anomalous experiences and of their misinterpretations. The purpose of the present study was to examine the relationship between cognitive insight and subjective quality of life in patients with schizophrenia to further shed light on the nature of cognitive insight and its functional correlates in schizophrenia. METHODS: Seventy-one stable outpatients with schizophrenia were evaluated for cognitive insight and subjective quality of life using the Beck Cognitive Insight Scale (BCIS) and the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4). The symptoms of schizophrenia were also assessed. Pearson's correlation analysis and partial correlation analysis that controlled for the severity of symptoms were performed to adjust for the possible effects of symptoms. RESULTS: The self-reflectiveness subscale score of the BCIS had significant positive correlations with the SQLS-R4 psychosocial domain and total SQLS-R4 scores, indicating that the higher the level of cognitive insight, the lower the subjective quality of life. In partial correlation analysis controlling for symptoms, the BCIS self-reflectiveness subscale score still had a significant correlation with the SQLS-R4 psychosocial domain score. The correlation coefficient between the BCIS self-reflectiveness and total SQLS-R4 scores was reduced to a nonsignificant statistical tendency. CONCLUSION: The results of our study suggest that cognitive insight, particularly the level of self-reflectiveness, is negatively associated with the level of subjective quality of life in outpatients with schizophrenia and that this relationship is not wholly due to the confounding effect of symptoms. Future studies are necessary to explore possible mediating and moderating factors and to evaluate the effects of therapeutic interventions on the relationship.
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Greater levels of cognitive insight are linked to heightened levels of depression, lower self-reported subjective recovery, and lower subjective quality of life.
“Greater levels of cognitive insight have also been linked to heightened levels of depression 77,86 , as well as lower levels of self-reported subjective recovery 89 and subjective quality of life 90 .”
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 [90]
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Zagajewska, A., Giba, A., Krygowska, A. M., Wąsik, M., Słupik, D., Reda, A., Śledziewska, A. M., Cyrkler, M., & Sieradocha, K. (2025) · Archiv Euromedica · doi:10.35630/2025/15/4.009
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
- Authors
- Kim, J.-H., Lee, S., Han, A.-Y., Kim, K., & Lee, J.
- Affiliations
- Gachon University (KR)
- Corresponding author
- Kim, Jong-Hoon
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2015-08
- Volume
- 11
- Pages
- 2041
- ISSN
- 1176-6328 (ISSN-L)
- 1178-2021
- PMC
- PMC4535546
- OpenAlex
- W1687556801
- Cited by
- 30
- References
- 70
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 1
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- Gachon University (GCU-2015-5031)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- cognitive insight, subjective quality of life, schizophrenia, self-reflection, Beck Cognitive Insight Scale, symptom severity, outpatients, psychosocial functioning
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