Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

Paul H. Lysaker, Michelle L. Pattison, Bethany L. Leonhardt, Scott Phelps, Jenifer Vohs

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others’ perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

Original languageEnglish (US)
Pages (from-to)12-23
Number of pages12
JournalWorld Psychiatry
Volume17
Issue number1
DOIs
StatePublished - Feb 1 2018

Fingerprint

Schizophrenia
Quality of Life
Research
Social Stigma
Politics
Depression
Education
Therapeutics

Keywords

  • antipsychotic medication
  • depression
  • Insight
  • metacognition
  • neurocognition
  • psychotherapy
  • quality of life
  • recovery
  • schizophrenia
  • social cognition
  • stigma
  • therapeutic alliance
  • treatment adherence

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health

Cite this

Insight in schizophrenia spectrum disorders : relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. / Lysaker, Paul H.; Pattison, Michelle L.; Leonhardt, Bethany L.; Phelps, Scott; Vohs, Jenifer.

In: World Psychiatry, Vol. 17, No. 1, 01.02.2018, p. 12-23.

Research output: Contribution to journalArticle

Lysaker, Paul H. ; Pattison, Michelle L. ; Leonhardt, Bethany L. ; Phelps, Scott ; Vohs, Jenifer. / Insight in schizophrenia spectrum disorders : relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. In: World Psychiatry. 2018 ; Vol. 17, No. 1. pp. 12-23.
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