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Psychosocial Treatment Compliance in Schizophrenia.

Lysaker PH; Bell MD; Milstein R; Bryson G & Beam Goulet J. Insight and

Psychiatry, Vol. 57, November 1994.

RELEVANCE FOR EARLY INTERVENTION

Unlike most studies of insight in the chronic mentally ill, this study evaluated patients when stabilized and enrolled in an outpatient work rehabilitation program. Patients with schizophrenia and schizoaffective disorder with poor insight had very poor adherence to the psychosocial treatment they had agreed to participate in despite a stated desire to work. Poorer insight was also correlated with lower scores on a test of frontal lobe function and with poorer performance on tests of other cognitive functions. The authors conclude that individuals with schizophrenia and poor insight have more problems remaining in a course of treatment regardless of whether it is pharmacologic or a psychosocial treatment they had expressed a desire to participate in. These data, like that of Young et. al., and Kasapis and colleagues, suggest that it is a mental defect that leads to lack of adherence with both pharmacologic and psychosocial treatments.

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