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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A neuropsychological etiology has been suggested for lack of insight in schizophrenia patients, mainly based on frontal, right parietal, right hemisphere, or diffuse cerebral dysfunctions. The aim of this study ws to investigate the neuropsychological pathogeny of lack of insight in schizophrenia patients. We examined a sample of 40 DSM-III-R schizophrenia inpatients admitted because of a recrudescence of symptoms. Schizophrenic symptoms were evaluated through the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms. Neurologic explorations included an assessment of frontal neurologic signs, abnormal involuntary movements, and soft neurologic signs. Lack of insight was assessed through three items from the Manual for the Assessment and Documentation of Psychopathology (AMDP). A global index from these three items (lack of feeling ill, lack of insight, and uncooperativeness) was obtained. A neuropsychological battery composed of tests involving many functional areas of the brain was used. No correlation between bad performance and lack of insight was found on any test. On the contrary, lack of insight was associated with better performance on immediate verbal, immediate visual, and delayed visual memory tasks. Moreover, the three components of lack of insight were extracted as an independent factor when they were included together with the positive and negative symptoms, neurologic abnormalities (frontal and soft neurologic signs, and abnormal movements), and a global measure of cognitive performance. The results of the study do not support the neuropsychological hypothesis of lack of insight.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lack of insight in schizophrenia. 808 37

This paper presents a selected review of the concept insight as regards recognition of the presence of illness among patients with psychotic disorders in general and with schizophrenia in particular and the development of new instruments for its assessment. Lack of insight appears to be a common pathway for different psychopathological processes and may have different meanings in different stages of the illness. Three major dimensions of the concept include: (1) awareness of having a mental illness; (2) the need for treatment; and (3) relabeling symptoms and signs as pathological and attributed to a mental illness. This complexity must be addressed by studies with a design using instruments which are appropriate to the research goals and carefully identify the stage of illness of the target population.
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PMID:Assessment of insight in psychotic disorders. 900 17

The present study investigated the relationships of psychopathological dimensions of schizophrenia with Insight in a sample of 100 acute schizophrenic patients. Lack of insight was significantly correlated with disorganized, excited and negative schizophrenic dimensions but not with other Positive and Negative Syndrome Scale dimensions. In addition, when insight was assessed through a multidimensional approach, a variety of relationships with the schizophrenic dimensions were found.
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PMID:Psychopathological dimensions and lack of insight in schizophrenia. 992 64

Patients suffering from schizophrenia have an impaired meta-representation also known as Theory of Mind (ToM). Moreover, the presence of delusions or other positive symptoms of schizophrenia has been correlated to poor ToM performances. Lack of insight is a common symptom of schizophrenia and can be considered a critical manifestation of impaired ToM abilities. In particular, the present study addresses the role of perspective ToM ability in schizophrenic patients. Thirty severely delusional schizophrenic patients completely lack insight when interviewed about their delusions. Seven subsequently gain insight about their mental state when perspective is shifted from the first person to third person. These data suggest that in some delusional schizophrenic patients, it may be possible to gain access to and modify their mental states.
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PMID:Theory of Mind in schizophrenia: first person vs third person perspective. 1499 Feb 39

Having a diagnosis of schizophrenia is a risk factor for involuntary admission to psychiatric inpatient care, but we have a limited understanding of why some patients and not others require involuntary admission. We aimed to identify the predictors of involuntary admission in first episode schizophrenia. We used validated instruments to assess clinical and socio-demographic variables in all patients (n = 78) with first episode schizophrenia from a defined geographical area admitted to a Dublin psychiatric hospital over a 4-year period. Involuntary patients (n = 17) could not be distinguished from voluntary patients (n = 61) on the basis of age, gender, living status, marital status, drug abuse or duration of untreated psychosis. Neither positive nor negative symptoms were useful predictors of admission status. Lack of insight was a strong predictor of involuntary status.
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PMID:Clinical predictors of admission status in first episode schizophrenia. 1505 Nov 4

Lack of insight of patients with schizophrenia into various aspects of their illness and treatment is an important clinical issue. Poor insight has been reported to be associated with neurocognitive deficits, particularly in the frontal and parietal functions. The aim of this study was to examine relationships between insight and cognitive and emotional function in patients with schizophrenia. Thirty-five male forensic patients suffering from chronic schizophrenia participated. The Scale for the Assessment of Unawareness of Mental Disorder was used to assess insight. Neuropsychological function was assessed with a comprehensive battery of tests. Clinical state was also assessed. Of 35 patients, 18 (51%) believed that they had a mental disorder. A similar proportion reported awareness of a need for medication and correctly attributed symptoms to illness. Measures of insight showed significant associations with visual object learning, verbal working memory, and identification of facial emotions but not with measures of frontal lobe function. Poorer insight was associated with a higher occurrence of violent events. Our findings support an association between poor insight and cognitive impairment in patients with chronic schizophrenia but suggest that the relationship may not specifically involve frontal lobe dysfunction.
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PMID:Insight into illness in schizophrenia. 1617 60

Poor insight into illness is a characteristic and common phenomenon in schizophrenic disorders. Lack of insight may lead to poor clinical outcome, thus, research focused on this phenomenon could help develop effective treatment strategies. The relationship between compliance with treatment and insight is complex and it may be influenced mostly by specific components of insight. The aim of the present study was to review the current definitions of insight, the tools and questionnaires used for its measurement, as well as the relationship between insight and psychopathological symptoms. Three theoretical models developed for the explanation of impaired insight are described; the Psychological Defence Model, the Cognitive Deficit Model, and the Neuropsychological Deficit Model. The neurocognitive bases of impaired insight is given special attention in this article. Administration of second generation antipsychotics and psychosocial interventions (psychoeducation with problem solving procedures and motivating techniques) can improve insight, and enhance compliance with treatment, thus, optimizing long-term therapeutic outcome for schizophrenia patients.
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PMID:[Insight into illness and compliance in schizophrenic disorders]. 1743 58

It is presently not known if lack of insight is related to physically aggressive behavior toward others among persons with schizophrenia, after controlling for known predictors such as psychopathy traits, and positive symptoms. Patients with schizophrenia (n = 209) were followed for 2 years after discharge. At discharge, psychopathy traits, insight and symptoms were assessed. At the beginning of each six-month period, insight and symptoms were assessed, whereas aggressive behavior, reported by patients and collateral informants, was assessed at the end of each period. Lack of insight was associated with aggressive behavior in univariate analyses but did not contribute to the prediction of aggressive behavior once scores for psychopathy and positive symptoms were entered into the model. The results demonstrate that among individuals with schizophrenia, aggressive behavior was more strongly associated with high scores for psychopathy traits and positive symptoms than with lack of insight.
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PMID:Is lack of insight associated with physically aggressive behavior among people with schizophrenia living in the community? 1819 43

Lack of insight is frequent in schizophrenia and usually influences negatively both patient's treatment and prognosis. This study aimed to investigate the relationship between insight, symptomatology and cognitive dysfunctions in schizophrenia using the PANSS five-factor model (modified from Gaag et al. in Schizophr Res 85:280-287, 2006). Forty patients diagnosed with chronic schizophrenia (DSM-IV) were evaluated with the scale to assess unawareness of mental disorder (SUMD), the PANSS and a neuropsychological battery. Spearman correlation and linear regression analyses were performed to investigate the relationship between clinical, neurocognitive and insight measures. The SUMD current and past awareness of symptoms score showed a correlation with WCST indices (correct answers and non-persevering errors). The negative and disorganization factor of the PANSS showed a positive correlation with current and past awareness of symptoms. However, when submitted to a linear regression model only the disorganization factor emerged as significant contributor for insight. Considering that the core items of the "disorganization factor" of the PANSS are related to cognition (e.g., poor attention, difficult in abstract thinking), insight is associated cognitive symptoms although no direct relationship between insight and neuropsychological tests was observed.
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PMID:Insight, cognitive dysfunction and symptomatology in schizophrenia. 1843 75

Lack of insight or awareness of illness is a hallmark feature of schizophrenic illness and has become an increasingly important area of investigation. Although clinical insight focuses on awareness of illness factors, the concept of cognitive insight focuses on the cognitive processes involved in correcting erroneous judgments and certainty about mistaken judgments. The present study was aimed at further investigating the clinical utility and the statistical coherence of the Beck Cognitive Insight Scale (BCIS) (Beck et al., 2004) in acute schizoaffective and schizophrenia (SZ) patients. The present study examined the internal consistency of the scale, as well as its discriminative and predictive validity relative to a well-established traditional measure of clinical insight in a sample of 50 DSM-IV diagnosed SZ patients, presenting for acute inpatient treatment. The BCIS was found to be an internally consistent and a coherent measure of cognitive insight. The BCIS was unassociated with clinical insight, indicating the 2 constructs share little empirical overlap. Cognitive insight was found to be inversely associated with patients' severity of autistic preoccupation symptoms such that those individuals with more cognitive insight, exhibited fewer autistic/cognitive symptoms. Patients' clinical insight, however, was found to be inversely associated specifically with patients' severity of depression. Additionally, clinical insight was also found to be more impaired in patients residing in nursing home environments relative to their counterparts living in less restrictive settings when outside the hospital. Results are discussed in terms of the relationship between clinical and cognitive insight constructs to SZ symptom domains.
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PMID:Examination of clinical and cognitive insight in acute schizophrenia patients. 2061 Oct 48


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