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Review

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

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Pages 1193-1204 | Received 08 Feb 2016, Accepted 06 Jun 2016, Published online: 22 Jun 2016

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Casandra Roy Gelencser, Geneviève Sauvé, Susanna Konsztowicz, Claude Bélanger & Martin Lepage. (2023) The impact of mental illness on self-concept: relationship between engulfment, cognitive insight, and depression in schizophrenia. Psychosis 15:4, pages 394-405.
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Abigail C. Wright, Paul H. Lysaker, David Fowler & Kathryn Greenwood. (2023) Clinical insight in first episode psychosis: the role of metacognition. Journal of Mental Health 32:1, pages 78-86.
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Wen Ling Hsieh, Shin Ting Yeh, Wen I Liu, I Hsien Li, Shih Kai Lee & Wai Tong Chien. (2022) Improving Medication Adherence in Community-Dwelling Patients with Schizophrenia Through Therapeutic Alliance and Medication Attitude: A Serial Multiple Mediation Model. Patient Preference and Adherence 16, pages 1017-1026.
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Joshua E. Mervis, Jenifer L. Vohs & Paul H. Lysaker. (2022) An update on clinical insight, cognitive insight, and introspective accuracy in schizophrenia-spectrum disorders: symptoms, cognition, and treatment. Expert Review of Neurotherapeutics 22:3, pages 245-255.
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Articles from other publishers (41)

LiHua Xu, TianYuan Zhu, YingYing Tang, XiaoChen Tang, ZhenYing Qian, YanYan Wei, HuiRu Cui, YeGang Hu, Dan Zhang, YingChan Wang, JunJuan Zhu, Hui Li, XiaoHua Liu, TianHong Zhang, XiangFei Hong & JiJun Wang. (2023) Impaired insight and error-monitoring deficits among outpatients with attenuated psychosis syndrome and first-episode psychosis. Journal of Psychiatric Research.
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Nesrin Çunkuş Köktaş, Gülay Taşdemir Yiğitoğlu & Ayşe Nur İnci Kenar. (2023) The effect of interpersonal relations theory-based motivational interviews on functional remission and insight levels of patients with schizophrenia: A randomized controlled trial. Archives of Psychiatric Nursing 45, pages 72-79.
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Gaël Galliot, Raquel Sanchez-Rodriguez, Alice Belloc, Hugo Phulpin, Adrien Icher, Philippe Birmes, Karine Faure & Tudi Gozé. (2022) Is clinical insight a determinant factor of subjective recovery in persons living with schizophrenia or schizoaffective disorders?. Psychiatry Research 316, pages 114726.
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Paul H. Lysaker, Peter J. Weiden, Xiaowu Sun, Amy K. O’Sullivan & Joseph P. McEvoy. (2022) Impaired insight in schizophrenia: impact on patient-reported and physician-reported outcome measures in a randomized controlled trial. BMC Psychiatry 22:1.
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Jun Gan, Hong Fu & Xiongzhao Zhu. (2022) Relationships Between Multiple Dimensions of Insight and Neurocognition, Metacognition, and Social Cognition. Journal of Nervous & Mental Disease 210:8, pages 577-584.
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Claudio Brasso, Silvio Bellino, Paola Bozzatello, Simona Cardillo, Cristiana Montemagni & Paola Rocca. (2022) The relative contributions of insight and neurocognition to intrinsic motivation in schizophrenia. Schizophrenia 8:1.
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Andrea Aguglia, Laura Fusar-Poli, Andrea Amerio, Valeria Placenti, Carmen Concerto, Giovanni Martinotti, Giuseppe Carrà, Francesco Bartoli, Armando D'Agostino, Gianluca Serafini, Mario Amore, Eugenio Aguglia, Giovanni Ostuzzi & Corrado Barbui. (2021) The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study. Frontiers in Psychiatry 12.
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Yasuhiro Ogawa, Keita Fukuhara, Hiroyuki Tanaka, Yuma Nagata, Daiki Ishimaru, Mizuki Urakawa & Takashi Nishikawa. (2021) Insight Into Illness and Psychological Defense Attitudes in People With Chronic Schizophrenia Using Markova's Insight Scale. Journal of Nervous & Mental Disease 209:12, pages 879-883.
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Joshua E. Mervis, Jamie Fischer, Samuel E. Cooper, Andrew C. Deckert, Paul H. Lysaker, Angus W. MacDonaldIIIIII & Piper Meyer-Kalos. (2021) Introspective accuracy for substance use across a year of treatment for first episode psychosis. Schizophrenia Research: Cognition 26, pages 100200.
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Teemu Mäntylä, Tuula Kieseppä, Jaana Suvisaari & Tuukka T. Raij. (2021) Delineating insight-processing-related functional activations in the precuneus in first-episode psychosis patients. Psychiatry Research: Neuroimaging 317, pages 111347.
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Paul H. Lysaker, Nikita Chernov, Tatyana Moiseeva, Marta Sozinova, Nadezhda Dmitryeva, Vitaliy Alyoshin, Lauren Luther, Olga Karpenko & Georgiy Kostyuk. (2021) Clinical insight, cognitive insight and metacognition in psychosis: Evidence of mediation. Journal of Psychiatric Research 140, pages 1-6.
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Michael F. Zito, Kenneth L. Subotnik, Joseph Ventura, Robert S. Kern, Michael F. Green & Keith H. Nuechterlein. (2021) Awareness of illness is associated with better social and nonsocial cognition in recent-onset schizophrenia. Schizophrenia Research 231, pages 51-53.
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Joshua E Mervis, Kelsey A Bonfils, Samuel E Cooper, Courtney Wiesepape & Paul H Lysaker. (2021) Co-occurring Deficits in Clinical and Cognitive Insight in Prolonged Schizophrenia-Spectrum Disorders: Relationship to Metacognitive Deficits. Schizophrenia Bulletin Open 2:1.
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Chin-Chao Ma, Yu-Chen Kao, Nian-Sheng Tzeng, Che-Yi Chao, Chuan-Chia Chang & Hsin-An Chang. (2020) A higher degree of insight impairment in stabilized schizophrenia patients is associated with reduced cardiac vagal tone as indexed by resting-state high-frequency heart rate variability. Asian Journal of Psychiatry 53, pages 102171.
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Jesus Cobo, Javier Labad, Esther Pousa, Lourdes Nieto, Susana Ochoa, Judith Usall, Carles García-Ribera, Iris Baños, Beatriz González, Carmina Massons, Isabel Ruiz & Ada I. Ruiz. (2020) Exploring the relationship of insight with psychopathology and gender in individuals with schizophrenia spectrum disorders with structural equation modelling. Archives of Women's Mental Health 23:5, pages 643-655.
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Frida K. Feyer, Stein Andersson, Camilla B. Büchmann, Ingrid Melle, Ole A. Andreassen & Anja Vaskinn. (2020) Social Perception Predicts Awareness of Illness in Persons With Schizophrenia. Journal of Nervous & Mental Disease 208:9, pages 701-705.
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G.H.M. Pijnenborg, D.I. Larabi, P. Xu, I. Hasson-Ohayon, A.E. de Vos, B. Ćurčić-Blake, A. Aleman & L. Van der Meer. (2020) Brain areas associated with clinical and cognitive insight in psychotic disorders: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews 116, pages 301-336.
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Ilanit Hasson-Ohayon, Anne Neeltje Scholte-Stalenhoef, Frederike Schirmbeck, Lieuwe de Haan, Wiepke Cahn, Gerdina Hendrika Maria Pijnenborg, Lindy-Lou Boyette, Therese van Amelsvoort, Agna A. Bartels-Velthuis, Richard Bruggeman, Wiepke Cahn, Lieuwe de Haan, Frederike Schirmbeck, Claudia J.P. Simons & Jim van Os. (2020) Insight, personality, and symptoms among individuals with psychosis: Cross-sectional and longitudinal relationships. Schizophrenia Research 222, pages 243-250.
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Bethany L. Leonhardt, Jenifer L. Vohs, Lisa A. Bartolomeo, Andrew Visco, William P. Hetrick, Amanda R. Bolbecker, Alan Breier, Paul H. Lysaker & Brian F. O’Donnell. (2019) Relationship of Metacognition and Insight to Neural Synchronization and Cognitive Function in Early Phase Psychosis. Clinical EEG and Neuroscience 51:4, pages 259-266.
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Geneviève Sauvé, Katie M. Lavigne, Gabrielle Pochiet, Mathieu B. Brodeur & Martin Lepage. (2020) Efficacy of psychological interventions targeting cognitive biases in schizophrenia: A systematic review and meta-analysis. Clinical Psychology Review 78, pages 101854.
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Mario Amore, Martino Belvederi Murri, Pietro Calcagno, Paola Rocca, Alessandro Rossi, Eugenio Aguglia, Antonello Bellomo, Giuseppe Blasi, Bernardo Carpiniello, Alessandro Cuomo, Liliana dell’Osso, Massimo di Giannantonio, Giulia Maria Giordano, Carlo Marchesi, Palmiero Monteleone, Cristiana Montemagni, Lucio Oldani, Maurizio Pompili, Rita Roncone, Rodolfo Rossi, Alberto Siracusano, Antonio Vita, Patrizia Zeppegno, Alessandro Corso, Costanza Arzani, Silvana Galderisi & Mario Maj. (2020) The association between insight and depressive symptoms in schizophrenia: Undirected and Bayesian network analyses. European Psychiatry 63:1.
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Shu‐Min Lu, Mei‐Feng Lin & Hsiu‐Ju Chang. (2019) Progressive muscle relaxation for patients with chronic schizophrenia: A randomized controlled study. Perspectives in Psychiatric Care 56:1, pages 86-94.
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Jesse Hochheiser, Nancy B. Lundin & Paul H. Lysaker. (2020) The Independent Relationships of Metacognition, Mindfulness, and Cognitive Insight to Self-Compassion in Schizophrenia. Journal of Nervous & Mental Disease 208:1, pages 1-6.
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Fumiko Kaneko & Hitoshi Okamura. (2019) Discrepancies between Self- and Clinical Staff Members’ Perception of Cognitive Functioning among Patients with Schizophrenia Undergoing Long-Term Hospitalization. Occupational Therapy International 2019, pages 1-10.
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Yasuhiro Ogawa, Keita Fukuhara, Hiroyuki Tanaka, Yuma Nagata, Daiki Ishimaru & Takashi Nishikawa. (2019) Insight Into Illness and Defense Styles in Schizophrenia. Journal of Nervous & Mental Disease 207:10, pages 815-819.
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Neha Ramu, Anna Kolliakou, Jyoti Sanyal, Rashmi Patel & Robert Stewart. (2019) Recorded poor insight as a predictor of service use outcomes: cohort study of patients with first-episode psychosis in a large mental healthcare database. BMJ Open 9:6, pages e028929.
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Paul H. Lysaker & Jenifer Vohs. (2019) Insight in schizophrenia, its fundamental connection to fragmentation and potential as a treatment target: A commentary on Phahladira et al.. Schizophrenia Research 208, pages 39-40.
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Geneviève Sauvé, Rex B. Kline, Jai L. Shah, Ridha Joober, Ashok Malla, Mathieu B. Brodeur & Martin Lepage. (2019) Cognitive capacity similarly predicts insight into symptoms in first- and multiple-episode psychosis. Schizophrenia Research 206, pages 236-243.
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G.H.M. Pijnenborg, A.E. de Vos, M.E. Timmerman, M. Van der Gaag, B.E. Sportel, J. Arends, E.M. Koopmans, L. Van der Meer & A. Aleman. (2019) Social cognitive group treatment for impaired insight in psychosis: A multicenter randomized controlled trial. Schizophrenia Research 206, pages 362-369.
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Martino Belvederi Murri & Mario Amore. (2019) The Multiple Dimensions of Insight in Schizophrenia-Spectrum Disorders. Schizophrenia Bulletin 45:2, pages 277-283.
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Michael R. Marriott, Andrew R. Thompson, Graham Cockshutt & Georgina Rowse. (2018) Narrative insight in psychosis: The relationship with spiritual and religious explanatory frameworks. Psychology and Psychotherapy: Theory, Research and Practice 92:1, pages 74-90.
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Paul H Lysaker, Emily Gagen, Abigail Wright, Jenifer L Vohs, Marina Kukla, Phillip T Yanos & Ilanit Hasson-Ohayon. (2019) Metacognitive Deficits Predict Impaired Insight in Schizophrenia Across Symptom Profiles: A Latent Class Analysis. Schizophrenia Bulletin 45:1, pages 48-56.
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Jaana Suvisaari, Outi Mantere, Jaakko Keinänen, Teemu Mäntylä, Eva Rikandi, Maija Lindgren, Tuula Kieseppä & Tuukka T. Raij. (2018) Is It Possible to Predict the Future in First-Episode Psychosis?. Frontiers in Psychiatry 9.
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Mehmet Kemal Arikan, Baris Metin, Sinem Zeynep Metin, Emine Elif Tülay & Nevzat Tarhan. (2018) High Frequencies in QEEG Are Related to the Level of Insight in Patients With Schizophrenia. Clinical EEG and Neuroscience 49:5, pages 316-320.
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Susanna Konsztowicz, Norbert Schmitz & Martin Lepage. (2018) Dimensions of insight in schizophrenia: Exploratory factor analysis of items from multiple self- and interviewer-rated measures of insight. Schizophrenia Research 199, pages 319-325.
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Mallory J. Klaunig, Christi L. Trask, Aaron M. Neis, Jonathan R. Cohn, Xuefang Chen, Alysia M. Berglund & David C. Cicero. (2018) Associations among domains of self-disturbance in schizophrenia. Psychiatry Research 267, pages 187-194.
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Floria H.N. Chio, Winnie W.S. Mak, Randolph C.H. Chan & Alan C.Y. Tong. (2018) Unraveling the insight paradox: One-year longitudinal study on the relationships between insight, self-stigma, and life satisfaction among people with schizophrenia spectrum disorders. Schizophrenia Research 197, pages 124-130.
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Tereza Petraskova Touskova. (2017) Disorganization and Insight in Schizophrenia. Activitas Nervosa Superior 60:1, pages 1-7.
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Paul H. Lysaker, Michelle L. Pattison, Bethany L. Leonhardt, Scott Phelps & Jenifer L. Vohs. (2018) Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry 17:1, pages 12-23.
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Jay A. Hamm, Kelly D. Buck & Jasmine D. Gonzalvo. (2017) Clinical Application of Patient-Centered Diabetes Care for People With Serious Mental Illness. Clinical Diabetes 35:5, pages 313-320.
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Nicolas Franck. (2016) Psychoéducation et troubles de l’insight dans la schizophrénie. La Presse Médicale 45:9, pages 742-748.
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