Insight and Rehabilitation of Patients with Schizophrenia - Abstract
Schizophrenia is a chronic severe mental disorder. Insight is defined as the ability to recognize the existence of a mental disorder. The time period of the article search is between 2000-2016. Journal articles and some books were included. Greater insight in individuals with schizophrenia is associated with high levels of dysphoria, lower self esteem and decreased well being and quality of life. Poor insight in patients with schizophrenia has been linked to more negative attitudes toward medication, longer episodes of antipsychotic non-adherence, more frequent hospitalization, and greater levels of positive and negative symptoms, lower self-esteem as well as poorer psychosocial function and quality of life. Clinical and cognitive insights are not the same. Clinical insight is the awareness of the clinical state and cognitive insight is the awareness of cognitive deficits. Good cognitive insight may be necessary for good clinical insight. Evidenced based treatments for individuals with schizophrenia should focus more systematically on the improvement of the insight. Cognitive behavioral therapy and various rehabilitation programs, such as the Integrated Psychological Therapy and the Integrated Neurocognitive Therapy can improve indirectly the insight. The metacognitive therapy and the metacognitive reflection and insight therapy can improve insight directly. Insight and medication adherence were found to be closely related. Insight impacts on the therapeutic alliance with mental health professionals. The assessment of insight is incorporated in many clinical scales. The improvement of the insight in people with schizophrenia should be a major therapeutic goal in the context of every evidenced based treatment in a long term.