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Review

Lack of awareness of illness in schizophrenia: conceptualizations, correlates and treatment approaches

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Pages 1035-1043 | Published online: 09 Jan 2014

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Maria Ruiz-Iriondo, Karmele Salaberría, Rocio Polo-López, Álvaro Iruin & Enrique Echeburúa. (2020) Improving clinical symptoms, functioning, and quality of life in chronic schizophrenia with an integrated psychological therapy (IPT) plus emotional management training (EMT): A controlled clinical trial. Psychotherapy Research 30:8, pages 1026-1038.
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Kristyna Vrbova, Jan Prasko, Michaela Holubova, Dana Kamaradova, Marie Ociskova, Marketa Marackova, Klara Latalova, Ales Grambal, Milos Slepecky & Marta Zatkova. (2016) Self-stigma and schizophrenia: a cross-sectional study. Neuropsychiatric Disease and Treatment 12, pages 3011-3020.
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Jenifer L. Vohs, Sunita George, Bethany L. Leonhardt & Paul H. Lysaker. (2016) An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments. Expert Review of Neurotherapeutics 16:10, pages 1193-1204.
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José Manuel Olivares, Köksal Alptekin, Jean-Michel Azorin, Fernando Cañas, Vincent Dubois, Robin Emsley, Philip Gorwood, Peter M Haddad, Dieter Naber, George Papageorgiou, Miquel Roca, Pierre Thomas, Guadalupe Martinez & Andreas Schreiner. (2013) Psychiatrists’ awareness of adherence to antipsychotic medication in patients with schizophrenia: results from a survey conducted across Europe, the Middle East, and Africa. Patient Preference and Adherence 7, pages 121-132.
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Paul H Lysaker, Jen Vohs, Jaclyn D Hillis, Marina Kukla, Raffaele Popolo, Giampaolo Salvatore & Giancarlo Dimaggio. (2013) Poor insight into schizophrenia: contributing factors, consequences and emerging treatment approaches. Expert Review of Neurotherapeutics 13:7, pages 785-793.
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Esteban Medina, Joan Salvà, Rubén Ampudia, Jorge Maurino & Juan Larumbe. (2012) Short-term clinical stability and lack of insight are associated with a negative attitude towards antipsychotic treatment at discharge in patients with schizophrenia and bipolar disorder. Patient Preference and Adherence 6, pages 623-629.
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CynthiaZ. Burton, Lea Vella & ElizabethW. Twamley. (2011) Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention. American Journal of Psychiatric Rehabilitation 14:4, pages 307-326.
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PaulH. Lysaker, MollyA. Erickson, Benjamin Buck, KellyD. Buck, Kyle Olesek, MeganL. A. Grant, Giampaolo Salvatore, Raffaele Popolo & Giancarlo Dimaggio. (2011) Metacognition and social function in schizophrenia: Associations over a period of five months. Cognitive Neuropsychiatry 16:3, pages 241-255.
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Katerine Osatuke, Mary Reid, WilliamB. Stiles, JohnW. Kasckow, Sidney Zisook & Somaia Mohamed. (2011) Narrative evolution and assimilation of problematic experiences in a case of pharmacotherapy for schizophrenia. Psychotherapy Research 21:1, pages 41-53.
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Articles from other publishers (58)

Antonino Messina, Giuseppe Cuccì, Caterina Crescimanno & Maria Salvina Signorelli. (2023) Clinical anatomy of the precuneus and pathogenesis of the schizophrenia. Anatomical Science International 98:4, pages 473-481.
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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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Mojtaba Habibi Asgarabad, Seyed Ruhollah Hosseini, Pardis Salehi Yegaei, Shahram Moradi & Paul H. Lysaker. (2022) Psychopathology and Poor Clinical Insight in Psychotic Patients. Journal of Nervous & Mental Disease 210:7, pages 532-540.
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Hsue-Wei Chan, Chin-Yu Huang & Yung-Chieh Yen. (2021) Clinical outcomes of paliperidone long-acting injection in patients with schizophrenia: a 1-year retrospective cohort study. BMC Psychiatry 21:1.
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John D. Little. (2020) In schizophrenia, are lack of capacity and lack of insight more usefully understood as anosognosia?. Australasian Psychiatry 29:3, pages 346-348.
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John D Little & Elliot Bell. (2020) Anosognosia and schizophrenia – a reminder. Australasian Psychiatry 29:3, pages 344-345.
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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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Guyonne Rogier, Andrea Caputo, Viviana Langher, Paul H. Lysaker, Giancarlo Dimaggio & Patrizia Velotti. (2019) Giving a Voice to Gambling Addiction: Analysis of Personal Narratives. Culture, Medicine, and Psychiatry 44:2, pages 159-174.
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Steven Jong, Ilanit Hasson‐Ohayon, Rozanne J.M. Donkersgoed, Marieke E. Timmerman, Mark Gaag, Andre Aleman, G.H. Marieke Pijnenborg & Paul H. Lysaker. (2019) Predicting therapy success from the outset: The moderating effect of insight into the illness on metacognitive psychotherapy outcome among persons with schizophrenia. Clinical Psychology & Psychotherapy 26:6, pages 650-660.
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C. Bouvet, C. Naudin & J. Zajac. (2019) Le concept d’insight narratif chez les personnes souffrant de schizophrénie : une revue systématique de la littérature. L'Encéphale 45:3, pages 256-262.
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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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Tae Yong KimJun Gee KimChul Kwon Kim. (2019) The Insight Paradox among Outpatients with Schizophrenia. Korean Journal of Schizophrenia Research 22:2, pages 56.
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S. de Jong, R. J. M. van Donkersgoed, M. E. Timmerman, M. aan het Rot, L. Wunderink, J. Arends, M. van Der Gaag, A. Aleman, P. H. Lysaker & G. H. M. Pijnenborg. (2018) Metacognitive reflection and insight therapy (MERIT) for patients with schizophrenia. Psychological Medicine 49:2, pages 303-313.
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Ilanit Hasson-Ohayon. (2018) Overlap and distinction between measures of insight and self-stigma. Psychiatry Research 266, pages 47-64.
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Y.-J. Lien, H.-A. Chang, Y.-C. Kao, N.-S. Tzeng, C.-W. Lu & C.-H. Loh. (2016) Insight, self-stigma and psychosocial outcomes in Schizophrenia: a structural equation modelling approach. Epidemiology and Psychiatric Sciences 27:2, pages 176-185.
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Tobias Feldhaus, Sebastian Falke, Lara von Gruchalla, Birgit Maisch, Christina Uhlmann, Eva Bock & Rebekka Lencer. (2018) The impact of self-stigmatization on medication attitude in schizophrenia patients. Psychiatry Research 261, pages 391-399.
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Patricia Ponce de León, Philip Gerretsen, Parita Shah, Ricardo Saracco-Alvarez, Ariel Graff-Guerrero & Ana Fresán. (2018) Cross-cultural psychometric assessment of the VAGUS insight into psychosis scale – Spanish version. Psychiatry Research 259, pages 450-454.
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S. Potvin, G. Aubin & E. Stip. (2017) L’insight neurocognitif dans la schizophrénie. L'Encéphale 43:1, pages 15-20.
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Bethany L. Leonhardt, Kelsey Benson, Sunita George, Kelly D. Buck, Rheannan Shaieb & Jenifer L. Vohs. (2016) Targeting Insight in First Episode Psychosis: A Case Study of Metacognitive Reflection Insight Therapy (MERIT). Journal of Contemporary Psychotherapy 46:4, pages 207-216.
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Lauren Luther, Michelle P. Salyers, Ruth L. Firmin, Matthew P. Marggraf, Beshaun Davis & Kyle S. Minor. (2016) Additional support for the cognitive model of schizophrenia: evidence of elevated defeatist beliefs in schizotypy. Comprehensive Psychiatry 68, pages 40-47.
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Ziyan Xu, Mario Müller, Karsten Heekeren, Anastasia Theodoridou, Sibylle Metzler, Diane Dvorsky, Nathalie Oexle, Susanne Walitza, Wulf Rössler & Nicolas Rüsch. (2016) Pathways between stigma and suicidal ideation among people at risk of psychosis. Schizophrenia Research 172:1-3, pages 184-188.
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Kevin K.S. Chan. (2016) Associations of symptoms, neurocognition, and metacognition with insight in schizophrenia spectrum disorders. Comprehensive Psychiatry 65, pages 63-69.
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Cynthia O. Siu, Philip D. Harvey, Ofer Agid, Mary Waye, Carla Brambilla, Wing-Kit Choi & Gary Remington. (2015) Insight and subjective measures of quality of life in chronic schizophrenia. Schizophrenia Research: Cognition 2:3, pages 127-132.
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R. Jørgensen, R.W. Licht, P.H. Lysaker, P. Munk-Jørgensen, K.D. Buck, S.O.W. Jensen, L. Hansson & V. Zoffmann. (2020) Effects on cognitive and clinical insight with the use of Guided Self-Determination in outpatients with schizophrenia: A randomized open trial. European Psychiatry 30:5, pages 655-663.
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Jenifer L. Vohs, Paul H. Lysaker, Emily Liffick, Michael M. Francis, Bethany L. Leonhardt, Alison James, Kelly D. Buck, Jay A. Hamm, Kyle S. Minor, Nikki Mehdiyoun & Alan Breier. (2015) Metacognitive Capacity as a Predictor of Insight in First-Episode Psychosis. Journal of Nervous & Mental Disease 203:5, pages 372-378.
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Doreen M. Olvet, Ricardo E. Carrión, Andrea M. Auther & Barbara A. Cornblatt. (2015) Self-awareness of functional impairment in individuals at clinical high-risk for psychosis. Early Intervention in Psychiatry 9:2, pages 100-107.
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Lizzette Gómez-de-Regil. (2015) Insight and illness perception in Mexican patients with psychosis. Schizophrenia Research: Cognition 2:1, pages 33-38.
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Lydia P. Ogden. (2014) “My Life as it is Has Value”. Qualitative Health Research 24:10, pages 1342-1355.
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Linda Pruß, Karl Heinz Wiedl & Manuel Waldorf. (2014) Der Beitrag subjektiver Krankheitsrepräsentationen zur Erklärung beeinträchtigter Krankheitseinsicht bei Schizophrenie. Zeitschrift für Klinische Psychologie und Psychotherapie 43:3, pages 162-170.
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Stéphane Raffard, Catherine Bortolon, Camille Rolland, Delphine Capdevielle, Jean-Philippe Boulenger, Marie-Christine Gely-Nargeot & Yannick Stephan. (2014) Memory self-efficacy in schizophrenia. Schizophrenia Research 156:1, pages 56-59.
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Jesse A. Bastiaens & Smita Agarkar. (2014) A Case Review of Poor Insight in Schizophrenia: How Much Do We Know?. Psychiatric Annals 44:5, pages 207-210.
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M. Cella, S. Swan, E. Medin, C. Reeder & T. Wykes. (2013) Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem. Psychological Medicine 44:3, pages 469-476.
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Solomon Teferra, Charlotte Hanlon, Teferra Beyero, Lars Jacobsson & Teshome Shibre. (2013) Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers. BMC Psychiatry 13:1.
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Antoon W.B. van Baars, André I. Wierdsma, Michiel W. Hengeveld & Cornelis L. Mulder. (2013) Improved insight affects social outcomes in involuntarily committed psychotic patients: A longitudinal study in the Netherlands. Comprehensive Psychiatry 54:7, pages 873-879.
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Maria Lalova, Franck Baylé, Marie-Laure Grillon, Laëtitia Houet, Elodie Moreau, Francis Rouam, Pascal Cacot & Pascale Piolino. (2013) Mechanisms of insight in schizophrenia and impact of cognitive remediation therapy. Comprehensive Psychiatry 54:4, pages 369-380.
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John Stratton, Philip T. Yanos & Paul Lysaker. (2013) Insight, Neurocognition, and Schizophrenia: Predictive Value of the Wisconsin Card Sorting Test. Schizophrenia Research and Treatment 2013, pages 1-6.
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Carol S. Aneshensel. 2013. Handbook of the Sociology of Mental Health. Handbook of the Sociology of Mental Health 603 620 .
Jose Manuel Montes, Esteban Medina, Manuel Gomez-Beneyto & Jorge Maurino. (2012) A short message service (SMS)-based strategy for enhancing adherence to antipsychotic medication in schizophrenia. Psychiatry Research 200:2-3, pages 89-95.
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R. Schennach, S. Meyer, F. Seemüller, M. Jäger, M. Schmauss, G. Laux, H. Pfeiffer, D. Naber, L.G. Schmidt, W. Gaebel, J. Klosterkötter, I. Heuser, W. Maier, M.R. Lemke, E. Rüther, S. Klingberg, M. Gastpar, H.-J. Möller & M. Riedel. (2012) Insight in schizophrenia–course and predictors during the acute treatment phase of patients suffering from a schizophrenia spectrum disorder. European Psychiatry 27:8, pages 625-633.
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Laurent Boyer, Michel Cermolacce, Daniel Dassa, Jessica Fernandez, Mohamed Boucekine, Raphaelle Richieri, Florence Vaillant, Remy Dumas, Pascal Auquier & Christophe Lancon. (2012) Neurocognition, Insight and Medication Nonadherence in Schizophrenia: A Structural Equation Modeling Approach. PLoS ONE 7:10, pages e47655.
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Anna Moriarty, Suzanne Jolley, Margie M. Callanan & Philippa Garety. (2012) Understanding reduced activity in psychosis: the roles of stigma and illness appraisals. Social Psychiatry and Psychiatric Epidemiology 47:10, pages 1685-1693.
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L. Boyer, V. Aghababian, R. Richieri, A. Loundou, R. Padovani, M.C. Simeoni, P. Auquier & C. Lançon. (2012) Insight into illness, neurocognition and quality of life in schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry 36:2, pages 271-276.
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