Insight and Schizophrenia: orrelates, Etiology and TreatmentAuthor(s): Paul H. Lysaker , Kelly D. Buck
Many patients with schizophrenia are unaware of the symptoms and course of their illness, as well as the need for treatment. As a result, they may be at greater risk not to recover. Exploring these issues, this paper reviews research, which suggests that unawareness of illness is linked with poorer clinical and psychosocial outcomes, though it may protect some from the negative impact of stigma. It also explores research suggesting that unawareness of illness may have diverse roots including deficits in neurocognition, as well as a wish to protect oneself from stigma. A range of treatments for unawareness of illness are detailed, which include cognitive behavior therapy, recovery-oriented integrative psychotherapy, motivational interviewing and psychosocial rehabilitation. While there is not sufficient research to point to the superiority of any of these treatments, they do share the common view that interventions must assist persons, in a nonauthoritative manner, to examine their thoughts and feelings about their circumstances and to construct a personally acceptable and consensually valid account of their barriers to wellness.