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Awareness of Illness
in Schizophrenia.
Schizophrenia Bulletin, 17:113-132, 1991.
Amador XF; Strauss DH; Yale SA & Gorman JM.
This paper reviews the extant literature on insight into
illness in schizophrenia. The authors argue for a reassessment of the problem and
consensus on terminology and measurement with the stated goal of stimulating scientific
research. Furthermore, they argue that poor insight in patients with schizophrenia may be
due to brain dysfunction. They point out numerous similarities between poor insight in
patients with schizophrenia and anosognosia (a neurological syndrome characterized by
unawareness of illness) in neurological patients. They conclude by offering
guidelines for terminology and research.
REVIEW ARTICLE
Ghaemi NS & Pope HG, Jr. Lack of Insight in Psychotic
and Affective Disorders : A Review of Empirical Studies. Harvard Review of Psychiatry,
May/June: 22-33, 1994.
This paper reviews the literature on insight in affective
psychoses. The authors remark that relatively little work has been done with this patient
group when compared to patients with schizophrenia. Nevertheless, as in schizophrenia,
studies of affective disorders find that lower levels of insight are correlated with a
poorer course of illness, lack of adherence to treatment and involuntary hospitalizations.
The authors also conclude that level of insight is also a trait, unrelated to other signs
of illness, in many patients.
EDITED BOOK
Amador XF & David A, Eds. Insight and
Psychosis. Edited volume, Oxford University Press, 1997.
In this book the neurological basis of deficits in illness
awareness is the focus of several chapters. In addition, data indicating that lower levels
of insight are associated with poorer illness course, increased exacerbations of illness,
greater number and longer duration of hospitalizations and non adherence to treatment are
reviewed. The role poor insight might play in violent behaviors is also discussed at
length.
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