An update on clinical insight, cognitive insight, and introspective accuracy in schizophrenia-spectrum disorders: symptoms, cognition, and treatment

References

• Lysaker PH, Pattison ML, Leonhardt BL, et al. Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry. 2018;17:12–23.
   PubMed Web of Science ®Google Scholar
• Belvederi Murri M, Respino M, Innamorati M, et al. Is good insight associated with depression among patients with schizophrenia? Systematic review and meta-analysis. Schizophr Res. 2015;162:234–247.
   PubMed Web of Science ®Google Scholar
• Palmer EC, Gilleen J, David AS. The relationship between cognitive insight and depression in psychosis and schizophrenia: a review and meta-analysis. Schizophr Res. 2015;166:261–268.
   PubMed Web of Science ®Google Scholar
• Vohs JL, George S, Leonhardt BL, et al. An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments. Expert Rev Neurother. 2016;16:1193–1204.
   PubMed Web of Science ®Google Scholar
• Lincoln TM, Lüllmann E, Rief W. Correlates and long-term consequences of poor insight in patients with schizophrenia. A systematic review. Schizophr Bull. 2007;33:1324–1342.
   PubMed Web of Science ®Google Scholar
• Beck AT, Baruch E, Balter JM, et al. A new instrument for measuring insight: the beck cognitive insight scale. Schizophr Res. 2004;68:319–329.
   PubMed Web of Science ®Google Scholar
• Nisbett RE, Wilson TD. Telling more than we can know: verbal reports on mental processes. Psychol Rev. 1977;84:231.
   Web of Science ®Google Scholar
• Gilleen J, Greenwood K, David AS. Domains of Awareness in Schizophrenia. Schizophr Bull. 2011;37:61–72.
   PubMed Web of Science ®Google Scholar
• Pinkham AE, Klein HS, Hardaway GB, et al. Neural correlates of social cognitive introspective accuracy in schizophrenia. Schizophr Res. 2018;202:166–172.
   PubMed Web of Science ®Google Scholar
• Silberstein J, Harvey PD. Impaired introspective accuracy in schizophrenia: an independent predictor of functional outcomes. Cogn Neuropsychiatry. 2019;24:28–39.
   PubMed Web of Science ®Google Scholar
• Springfield CR, Pinkham AE. Introspective accuracy for social competence in psychometric schizotypy. Cognit Neuropsychiatry. 2020;25:57–70.
   PubMed Web of Science ®Google Scholar
• Garcia-Cabeza I, Victor F, de Portugal E. Relationship between insight, adherence and disability in the diagnose of paranoid schizophrenia. J Ment Health Clin Psychol. 2018;2.
   Google Scholar
• Elowe J, Golay P, Baumann PS, et al. Moderating role of cannabis use between insight and depression in early psychosis. Schizophr Res. 2020;215:61–65.
   PubMed Web of Science ®Google Scholar
• Kim J, Ozzoude M, Nakajima S, et al. Insight and medication adherence in schizophrenia: an analysis of the CATIE trial. Neuropharmacology. 2020;168:107634.
   PubMed Web of Science ®Google Scholar
• Czobor P, Van Dorn RA, Citrome L, et al. Treatment adherence in schizophrenia: a patient-level meta-analysis of combined CATIE and EUFEST studies. Eur Neuropsychopharmacol J Eur Coll Neuropsychopharmacol. 2015;25:1158–1166.
   PubMed Web of Science ®Google Scholar
• Yaegashi H, Kirino S, Remington G, et al. Adherence to oral antipsychotics measured by electronic adherence monitoring in schizophrenia: a systematic review and meta-analysis. CNS Drugs. 2020;34:579–598.
   PubMed Web of Science ®Google Scholar
• Marucci C, Santarelli V, Collazzoni A, et al. Which metacognitive components of insight in schizophrenia? The relationship between subjective and objective measures of metacognition and insight. J Psychopathol. 2019;25:18–23.
   Web of Science ®Google Scholar
• Ozzoude M, Nakajima S, Plitman E, et al. The effects of illness severity, cognition, and estimated antipsychotic dopamine receptor occupancy on insight into the illness in schizophrenia: an analysis of clinical antipsychotic trials of intervention effectiveness (CATIE) data. Prog Neuropsychopharmacol Biol Psychiatry. 2019;89:207–213.
   PubMed Web of Science ®Google Scholar
• Tiryaki A, Karahan A, Civil Arslan F. The relationship of insight with psychopathology and neuropsychological functioning in patients with Schizophrenia. Turk J Psychiatry. 2018;29(1):22-30.
   Google Scholar
• Tariku M, Demilew D, Fanta T, et al. Insight and associated factors among patients with schizophrenia in mental specialized hospital, Ethiopia, 2018. Psychiatry J. 2019;2019:1–5.
   Google Scholar
• Atoui M, El Jamil F, El Khoury J, et al. The relationship between clinical insight and cognitive and affective empathy in schizophrenia. Schizophr Res Cogn. 2018;12:56–65.
   PubMedGoogle Scholar
• Hasson-Ohayon I, Scholte-Stalenhoef AN, Schirmbeck F, et al. Insight, personality, and symptoms among individuals with psychosis: cross-sectional and longitudinal relationships. Schizophr Res. 2020;222:243–250.
   PubMed Web of Science ®Google Scholar
• Phahladira L, Asmal L, Kilian S, et al. Changes in insight over the first 24 months of treatment in schizophrenia spectrum disorders. Schizophr Res. 2019;206:394–399.
   PubMed Web of Science ®Google Scholar
• Cohen CI, Mani A, Ghezelaiagh B. A longitudinal study of illness awareness in older adults with schizophrenia. Am J Geriatr Psychiatry. 2019;27:200–209.
   PubMed Web of Science ®Google Scholar
• Spikol A, Murphy J. ‘Something wasn’t quite right’: a novel phenomenological analysis of internet discussion posts detailing initial awareness of psychosis. Clin Schizophr Relat Psychoses. 2019. DOI:https://doi.org/10.3371/CSRP.SPJM.032819
   Google Scholar
• Drake RJ, Haley CJ, Akhtar S, et al. Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry. 2000;177:511–515.
   PubMed Web of Science ®Google Scholar
• Li W, Zhang -H-H, Wang Y, et al. Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies. Psychiatr Q. 2020;91:1–15.
   PubMed Web of Science ®Google Scholar
• Subotnik KL, Ventura J, Hellemann GS, et al. Relationship of poor insight to neurocognition, social cognition, and psychiatric symptoms in schizophrenia: a meta-analysis. Schizophr Res. 2020;220:164–171.
   PubMed Web of Science ®Google Scholar
• Kamble KS, Nayak AS, Kumar AV. An observational study of clinical subtypes in treatment-resistant schizophrenia and its relation with cognitive insight. Ann Indian Psychiatry. 2020;4:154.
   Google Scholar
• Liu J, Chan TC, Chong SA, et al. Impact of emotion dysregulation and cognitive insight on psychotic and depressive symptoms during the early course of schizophrenia spectrum disorders. Early Interv Psychiatry. 2020;14:691–697.
   PubMed Web of Science ®Google Scholar
• García-Mieres H, De Jesús-Romero R, Ochoa S, et al. Beyond the cognitive insight paradox: self-reflectivity moderates the relationship between depressive symptoms and general psychological distress in psychosis. Schizophr Res. 2020;222:297–303.
   PubMed Web of Science ®Google Scholar
• Dondé C, Laprévote V, Lavallé L, et al. Cognitive insight in individuals with an at‐risk mental state for psychosis: a meta‐analysis. Early Interv Psychiatry. 2020;15:449–456.
   PubMed Web of Science ®Google Scholar
• Pinho LG, Sampaio F, Sequeira C, et al. Cognitive insight in psychotic patients institutionalized and living in the community: an examination using the Beck Cognitive Insight Scale. Psychiatry Res. 2020;295:113586.
   PubMed Web of Science ®Google Scholar
• Rathee R, Luhrmann TM, Bhatia T, et al. Cognitive insight and objective quality of life in people with schizophrenia and auditory hallucinations. Psychiatry Res. 2018;259:223–228.
   PubMed Web of Science ®Google Scholar
• Silberstein JM, Pinkham AE, Penn DL, et al. Self-assessment of social cognitive ability in schizophrenia: association with social cognitive test performance, informant assessments of social cognitive ability, and everyday outcomes. Schizophr Res. 2018;199:75–82.
   PubMed Web of Science ®Google Scholar
• Pinkham AE, Harvey PD, Penn DL. Social cognition psychometric evaluation: results of the final validation study. Schizophr Bull. 2018;44:737–748.
   PubMed Web of Science ®Google Scholar
• Olsson A-K, Hjärthag F, Helldin L. Overestimated function in patients with schizophrenia: a possible risk factor for inadequate support? Schizophr Res. 2019;206:194–199.
   PubMed Web of Science ®Google Scholar
• Gould F, McGuire LS, Durand D, et al. Self-assessment in schizophrenia: accuracy of evaluation of cognition and everyday functioning. Neuropsychology. 2015;29:675.
   PubMed Web of Science ®Google Scholar
• Nishida K, Toyomaki A, Koshikawa Y, et al. Social cognition and metacognition contribute to accuracy for self-evaluation of real-world functioning in patients with schizophrenia. Schizophr Res. 2018;202:426–428.
   PubMed Web of Science ®Google Scholar
• Kaneko F, Okamura H. Discrepancies between self- and clinical staff members’ perception of cognitive functioning among patients with schizophrenia undergoing long-term hospitalization. Occup Ther Int. 2019;2019:e6547096.
   PubMed Web of Science ®Google Scholar
• Harris MT, Rempfer MV. Profiles of self-evaluation as a metacognitive skill: an indicator of rehabilitation potential among people with schizophrenia. Psychiatr Rehabil J. 2020;43:308.
   PubMed Web of Science ®Google Scholar
• Belvederi Murri M, Amore M, Calcagno P, et al. The “Insight Paradox” in Schizophrenia: magnitude, moderators and mediators of the association between insight and depression. Schizophr Bull. 2016;42:1225–1233.
   PubMed Web of Science ®Google Scholar
• Buchman-Wildbaum T, Váradi E, Schmelowszky Á, et al. The paradoxical role of insight in mental illness: the experience of stigma and shame in schizophrenia, mood disorders, and anxiety disorders. Arch Psychiatr Nurs. 2020;34:449–457.
   PubMed Web of Science ®Google Scholar
• Davis BJ, Lysaker PH, Salyers MP, et al. The insight paradox in schizophrenia: a meta-analysis of the relationship between clinical insight and quality of life. Schizophr Res. 2020 [cited 2020 Sep 11]; Available from 2020 Sep 11]; 223:9–17. Internet http://www.sciencedirect.com/science/article/pii/S0920996420304035
   PubMed Web of Science ®Google Scholar
• Lysaker PH, Kukla M, Leonhardt BL, et al. Meaning, integration, and the self in serious mental illness: implications of research in metacognition for psychiatric rehabilitation. Psychiatr Rehabil J. 2020;43:275–283.
   PubMed Web of Science ®Google Scholar
• Lysaker PH, Minor KS, Lysaker JT, et al. Metacognitive function and fragmentation in schizophrenia: relationship to cognition, self-experience and developing treatments. Schizophr Res Cogn. 2020;19:100142.
   PubMedGoogle Scholar
• Chuang SP, Wu JYW, Wang CS. Self-perception of mental illness, and subjective and objective cognitive functioning in people with schizophrenia. Neuropsychiatr Dis Treat. 2019;15:967.
   PubMed Web of Science ®Google Scholar
• Lien Y-J, Chang H-A, Kao Y-C, et al. The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2018;268:27–38.
   PubMed Web of Science ®Google Scholar
• Chio FH, Mak WW, Chan RC, et al. Unraveling the insight paradox: one-year longitudinal study on the relationships between insight, self-stigma, and life satisfaction among people with schizophrenia spectrum disorders. Schizophr Res. 2018;197:124–130.
   PubMed Web of Science ®Google Scholar
• Grover S, Sahoo S, Chakrabarti S, et al. Association of internalized stigma and insight in patients with schizophrenia. Int J Cult Ment Health. 2018;11:338–350.
   Google Scholar
• Schandrin A, Norton J, Raffard S, et al. A multi-dimensional approach to the relationship between insight and aggressiveness in schizophrenia: findings from the FACE-SZ cohort. Schizophr Res. 2019;204:38–45.
   PubMed Web of Science ®Google Scholar
• Reinharth J, Reynolds G, Dill C, et al. Cognitive predictors of violence in schizophrenia: a meta-analytic review. Schizophr Res Cogn. 2014;1:101–111.
   Google Scholar
• Santarelli V, Marucci C, Collazzoni A, et al. Could the severity of symptoms of schizophrenia affect ability of self-appraisal of cognitive deficits in patients with schizophrenia? Lack of insight as a mediator between the two domains. Eur Arch Psychiatry Clin Neurosci. 2020;270(6):723-728.
   PubMed Web of Science ®Google Scholar
• Arraras JI, Ibañez B, Pereda N, et al. The association of clinical insight and depression with quality of life in schizophrenia. Psychiatry Res. 2019;279:350–352.
   PubMed Web of Science ®Google Scholar
• Konsztowicz S, Lepage M. The role of illness engulfment in the association between insight and depressive symptomatology in schizophrenia. J Psychiatr Res. 2019;111:1–7.
   PubMed Web of Science ®Google Scholar
• Ramu N, Kolliakou A, Sanyal J, et al. 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. 2019;9:e028929.
   PubMed Web of Science ®Google Scholar
• Ayesa-Arriola R, Terán JMP, Moríñigo JDL, et al. The dynamic relationship between insight and suicidal behavior in first episode psychosis patients over 3-year follow-up. Eur Neuropsychopharmacol. 2018;28:1161–1172.
   PubMed Web of Science ®Google Scholar
• Hochheiser J, Lundin NB, Lysaker PH. The independent relationships of metacognition, mindfulness, and cognitive insight to self-compassion in schizophrenia. J Nerv Ment Dis. 2020;208:1–6.
   PubMed Web of Science ®Google Scholar
• Villa J, Choi J, Kangas JL, et al. Associations of suicidality with cognitive ability and cognitive insight in outpatients with schizophrenia. Schizophr Res. 2018;192:340–344.
   PubMed Web of Science ®Google Scholar
• Ozturk HM, Yuksel N, Utku C. Relationship between suicide attempt and cognitive functions, hopelessness, insight in schizophrenia/Sizofreni hastalarinda intihar girisiminin bilissel islevler, umutsuzluk ve ic goru ile iliskisi. Anadolu Psikiyatri Derg. 2018;19:256–264.
   Web of Science ®Google Scholar
• Verma D, Srivastava M, Singh SK, et al. Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders. Schizophr Res. 2016;178:12–16.
   PubMed Web of Science ®Google Scholar
• Harvey PD, Twamley EW, Pinkham AE, et al. Depression in Schizophrenia: associations with cognition, functional capacity, everyday functioning, and self-assessment. Schizophr Bull. 2017;43:575–582.
   PubMed Web of Science ®Google Scholar
• Siu CO, Harvey PD, Agid O, et al. Insight and subjective measures of quality of life in chronic schizophrenia. Schizophr Res Cogn. 2015;2:127–132.
   PubMedGoogle Scholar
• Harvey PD, Deckler E, Jones MT, et al. Autism symptoms, depression, and active social avoidance in schizophrenia: association with self-reports and informant assessments of everyday functioning. J Psychiatr Res. 2019;115:36–42.
   PubMed Web of Science ®Google Scholar
• Jones MT, Deckler E, Laurrari C, et al. Confidence, performance, and accuracy of self-assessment of social cognition: a comparison of schizophrenia patients and healthy controls. Schizophr Res Cogn. 2020;19:100133.
   Google Scholar
• Raffard S, Lebrun C, Bayard S, et al. Self-Awareness Deficits of Cognitive Impairment in Individuals With Schizophrenia. Really? Front Psychiatry. 2020;11:11.
   PubMed Web of Science ®Google Scholar
• Ćurčić‐Blake B, van der ML, Pijnenborg GHM, et al. Insight and psychosis: functional and anatomical brain connectivity and self‐reflection in Schizophrenia. Hum Brain Mapp. 2015;36:4859–4868.
   PubMed Web of Science ®Google Scholar
• van der Meer L, Costafreda S, Aleman A, et al. Self-reflection and the brain: a theoretical review and meta-analysis of neuroimaging studies with implications for schizophrenia. Neurosci Biobehav Rev. 2010;34:935–946.
   PubMed Web of Science ®Google Scholar
• Aleman A, Agrawal N, Morgan KD, et al. Insight in psychosis and neuropsychological function: meta-analysis. Br J Psychiatry. 2006;189:204–212.
   PubMed Web of Science ®Google Scholar
• Fusar‐Poli P, McGorry PD, Kane JM. Improving outcomes of first‐episode psychosis: an overview. World Psychiatry. 2017;16:251–265.
   PubMed Web of Science ®Google Scholar
• Leonhardt BL, Vohs JL, Bartolomeo LA, et al. Relationship of metacognition and insight to neural synchronization and cognitive function in early phase psychosis. Clin EEG Neurosci. 2020;51:259–266.
   PubMed Web of Science ®Google Scholar
• Sauvé G, Kline RB, Shah JL, et al. Cognitive capacity similarly predicts insight into symptoms in first-and multiple-episode psychosis. Schizophr Res. 2019;206:236–243.
   PubMed Web of Science ®Google Scholar
• Othman Z, Lua CT. Clinical insight in schizophrenia is associated with verbal delayed recall. Int Med J. 2018;25:153–156.
   Google Scholar
• Raveendranathan D, Joseph J, Machado T, et al. Neurocognitive and clinical correlates of insight in schizophrenia. Indian J Psychiatry. 2020;62:131.
   PubMed Web of Science ®Google Scholar
• Khalil AH, El-Meguid MA, Bastawy M, et al. Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia. Int J Soc Psychiatry. 2020;66:240–248.
   PubMed Web of Science ®Google Scholar
• Baliga SP, Kamath RM, Kedare JS. Subjective cognitive complaints and its relation to objective cognitive performance, clinical profile, clinical insight, and social functioning in patients of schizophrenia: a cross-sectional study. Indian J Psychiatry. 2020;62:178.
   PubMed Web of Science ®Google Scholar
• Daniell K, Kim J, Iwata Y, et al. Exploring the relationship between impaired illness awareness and visuospatial inattention in patients with schizophrenia. J Psychiatr Res. 2021 [cited 2020 Oct 24]; Available from 2020 Oct 24]; 136:468–473. Internet http://www.sciencedirect.com/science/article/pii/S0022395620310190
   PubMed Web of Science ®Google Scholar
• Addington J, Girard TA, Christensen BK, et al. Social cognition mediates illness-related and cognitive influences on social function in patients with schizophrenia-spectrum disorders. J Psychiatry Neurosci JPN. 2010;35:49–54.
   PubMed Web of Science ®Google Scholar
• Lin C-H, Huang C-L, Chang Y-C, et al. Clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia. Schizophr Res. 2013;146:231–237.
   PubMed Web of Science ®Google Scholar
• Schmidt SJ, Mueller DR, Roder V. Social cognition as a mediator variable between neurocognition and functional outcome in schizophrenia: empirical review and new results by structural equation modeling. Schizophr Bull. 2011;37:S41–S54.
   PubMed Web of Science ®Google Scholar
• Bora E. Relationship between insight and theory of mind in schizophrenia: a meta-analysis. Schizophr Res. 2017;190:11–17.
   PubMed Web of Science ®Google Scholar
• Feyer FK, Andersson S, Büchmann CB, et al. Social perception predicts awareness of illness in persons with Schizophrenia. J Nerv Ment Dis. 2020;208:701–705.
   PubMed Web of Science ®Google Scholar
• Lysaker PH, Gagen E, Wright A, et al. Metacognitive deficits predict impaired insight in schizophrenia across symptom profiles: a latent class analysis. Schizophr Bull. 2019;45:48–56.
   PubMed Web of Science ®Google Scholar
• Grover S, Sahoo S, Nehra R, et al. Association of neurocognitive deficits and insight in schizophrenia. Asian J Psychiatr. 2018;36:112–117.
   PubMed Web of Science ®Google Scholar
• Expósito MS, Felipe-Castaño E. Cognitive insight, neurocognition and life skills in patients with schizophrenia. Psicothema. 2018;30:251–256.
   PubMed Web of Science ®Google Scholar
• Ohmuro N, Katsura M, Obara C, et al. The relationship between cognitive insight and cognitive performance among individuals with at-risk mental state for developing psychosis. Schizophr Res. 2018;192:281–286.
   PubMed Web of Science ®Google Scholar
• Bredemeier K, Beck AT, Grant PM. Exploring the temporal relationship between cognitive insight and neurocognition in schizophrenia: a prospective analysis. Clin Psychol Sci. 2018;6:76–89.
   Web of Science ®Google Scholar
• Othman Z, Lua CT. Cognitive insight in schizophrenia: its relationship with verbal learning and clinical insight. Int Med J. 2018;25:147–152.
   Google Scholar
• Perez MM, Tercero BA, Penn DL, et al. Overconfidence in social cognitive decision making: correlations with social cognitive and neurocognitive performance in participants with schizophrenia and healthy individuals. Schizophr Res. 2020;224:51–57.
   PubMed Web of Science ®Google Scholar
• Dietrichkeit M, Grzella K, Nagel M, et al. Using virtual reality to explore differences in memory biases and cognitive insight in people with psychosis and healthy controls. Psychiatry Res. 2020;285:112787.
   PubMed Web of Science ®Google Scholar
• Klein HS, Pinkham AE. Examining reasoning biases in schizophrenia using a modified “Jumping to Conclusions” probabilistic reasoning task. Psychiatry Res. 2018;270:180–186.
   PubMed Web of Science ®Google Scholar
• Pijnenborg GH, van Donkersgoed RJ, David AS, et al. Changes in insight during treatment for psychotic disorders: a meta-analysis. Schizophr Res. 2013;144:109–117.
   PubMed Web of Science ®Google Scholar
• Lysaker PH, Klion RE. Recovery, meaning-making, and severe mental illness: a comprehensive guide to metacognitive reflection and insight therapy. New York: Routledge; 2017.
   Google Scholar
• Vohs JL, Leonhardt BL, James AV, et al. Metacognitive reflection and insight therapy for early psychosis: a preliminary study of a novel integrative psychotherapy. Schizophr Res. 2018;195:428–433.
   PubMed Web of Science ®Google Scholar
• Lysaker PH, Gagen E, Moritz S, et al. Metacognitive approaches to the treatment of psychosis: a comparison of four approaches. Psychol Res Behav Manag. 2018;11:341-351.
   Web of Science ®Google Scholar
• Pijnenborg G, de Vos A, Timmerman M, et al. Social cognitive group treatment for impaired insight in psychosis: a multicenter randomized controlled trial. Schizophr Res. 2019;206:362–369.
   PubMed Web of Science ®Google Scholar
• Budak FK, Yilmaz E. The effect of yoga on clinical insight and medication adherence in patients with schizophrenia-A randomized controlled trial. Eur J Integr Med. 2019;30:100949.
   Web of Science ®Google Scholar
• Şenormancı G, Korkmaz N, Şenormancı Ö, et al. Effects of exercise on resilience, insight and functionality in patients with chronic Schizophrenia in a psychiatric nursing home setting: a randomized controlled trial. Issues Ment Health Nurs. 2020;41:1–19.
   PubMed Web of Science ®Google Scholar
• Dondé C, Senn M, Eche J, et al. Well-informed but not aware: the PACT® psychoeducation program for schizophrenia improves knowledge about, but not insight into, the illness. Asian J Psychiatr. 2019;46:15–18.
   PubMed Web of Science ®Google Scholar
• Birulés I, López-Carrilero R, Cuadras D, et al. Cognitive insight in first-episode psychosis: changes during metacognitive training. J Pers Med. 2020;10:253.
   Web of Science ®Google Scholar
• Salas-Sender M, López-Carrilero R, Barajas A, et al. Gender differences in response to metacognitive training in people with first-episode psychosis. J Consult Clin Psychol. 2020;88:516–525.
   PubMed Web of Science ®Google Scholar
• Simón-Expósito M, Felipe-Castaño E. Effects of metacognitive training on cognitive insight in a sample of patients with Schizophrenia. Int J Environ Res Public Health. 2019;16:4541.
   Web of Science ®Google Scholar
• Moritz S, Mahlke CI, Westermann S, et al. Embracing psychosis: a cognitive insight intervention improves personal narratives and meaning-making in patients with schizophrenia. Schizophr Bull. 2018;44:307–316.
   PubMed Web of Science ®Google Scholar
• de Jong S, Van Donkersgoed R, Timmerman M, et al. Metacognitive reflection and insight therapy (MERIT) for patients with schizophrenia. Psychol Med. 2019;49:303–313.
   PubMed Web of Science ®Google Scholar
• Lopez-Morinigo J-D, Ajnakina O, Martínez AS-E, et al. Can metacognitive interventions improve insight in schizophrenia spectrum disorders? A systematic review and meta-analysis. Psychol Med. 2020;50(14):2289-2301.
   PubMed Web of Science ®Google Scholar
• Jansen JE, Gleeson J, Bendall S, et al. Acceptance- and mindfulness-based interventions for persons with psychosis: a systematic review and meta-analysis. Schizophr Res. 2020;215:25–37.
   PubMed Web of Science ®Google Scholar
• Louise S, Fitzpatrick M, Strauss C, et al. Mindfulness- and acceptance-based interventions for psychosis: our current understanding and a meta-analysis. Schizophr Res. 2018;192:57–63.
   PubMed Web of Science ®Google Scholar
• Yılmaz E, Okanlı A. Test of mindfulness-based psychosocial skills training to improve insight and functional recovery in schizophrenia. West J Nurs Res. 2018;40:1357–1373.
   PubMed Web of Science ®Google Scholar
• Yüksel A, Bahadır-Yılmaz E. The effect of mindfulness-based psychosocial skills training on functioning and insight level in patients with Schizophrenia. Community Ment Health J. 2021;;57(2):365-371.
   PubMed Web of Science ®Google Scholar
• Çetin N, Aylaz R. The effect of mindfulness-based psychoeducation on insight and medication adherence of schizophrenia patients. Arch Psychiatr Nurs. 2018;32(5):737–744.
   PubMed Web of Science ®Google Scholar
• Halverson T, Jarskog LF, Pedersen C, et al. Effects of oxytocin on empathy, introspective accuracy, and social symptoms in schizophrenia: a 12-week twice-daily randomized controlled trial. Schizophr Res. 2019;204:178–182.
   PubMed Web of Science ®Google Scholar
• Green MF, Horan WP, Lee J. Nonsocial and social cognition in schizophrenia: current evidence and future directions. World Psychiatry. 2019;18:146–161.
   PubMed Web of Science ®Google Scholar
• Perkins DO, Gu H, Boteva K, et al. Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry. 2005;162:1785–1804.
   PubMed Web of Science ®Google Scholar
• Perkins DO, Johnson JL, Hamer RM, et al. Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. Schizophr Res. 2006;83:53–63.
   PubMed Web of Science ®Google Scholar
• de León PP, Gerretsen P, Shah P, et al. Cross-cultural psychometric assessment of the VAGUS insight into psychosis scale–Spanish version. Psychiatry Res. 2018;259:450–454.
   PubMed Web of Science ®Google Scholar
• Garg R, Cheema SK, Raj R. Psychometric properties of the insight in psychosis questionnaire and its correlation to psychopathology in indian population. Indian J Psychol Med. 2018;40:113–120.
   PubMedGoogle Scholar
• Jacob A, Shukla A, Thonse U, et al. Cultural differences and neural correlates of cognitive insight in schizophrenia. Schizophr Res. 2019;209:98–104.
   PubMed Web of Science ®Google Scholar
• Chiesa A. Vipassana meditation: systematic review of current evidence. J Altern Complement Med. 2010;16:37–46.
   PubMed Web of Science ®Google Scholar
• Krygier JR, Heathers JAJ, Shahrestani S, et al. Mindfulness meditation, well-being, and heart rate variability: a preliminary investigation into the impact of intensive Vipassana meditation. Int J Psychophysiol. 2013;89:305–313.
   PubMed Web of Science ®Google Scholar
• Schlieter J. Buddhist insight meditation (Vipassanā) and Jon Kabat-Zinn’s “mindfulness-based stress reduction”: an example of dedifferentiation of religion and medicine? J Contemp Relig. 2017;32:447–463.
   Web of Science ®Google Scholar
• Amador XF, Gorman JM. Psychopathologic domains and insight in schizophrenia. Psychiatr Clin North Am. 1998;21:27–42.
   PubMed Web of Science ®Google Scholar
• Raftery D, Kelly PJ, Deane FP, et al. Insight in substance use disorder: a systematic review of the literature. Addict Behav. 2020;111:106549.
   PubMed Web of Science ®Google Scholar
• Raftery D, Kelly PJ, Deane FP, et al. Measuring cognitive insight in people with problematic substance use: an exploration of the factor validity of the beck cognitive insight scale. Drug Alcohol Rev. 2019;38:622–629.
   PubMed Web of Science ®Google Scholar
• Cohen J. A power primer. Psychol Bull. 1992;112:155.
   PubMed Web of Science ®Google Scholar