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Insight and the Clinical Outcome of Schizophrenic Patients.

McEvoy JP, Freter S, Everett G, Geller JL, Appelbaum PS, Apperson LJ & Roth L. (1989).

Journal of Nervous and Mental Disease, 177(1): 48-51.

RELEVANCE FOR EARLY INTERVENTION

Patients with schizophrenia were followed from 2 � to 3 � years after discharge from the hospital. Although symptoms of psychosis improved in nearly all of the patients over the course of the initial hospitalization, improvement in insight was seen only in those patients who had voluntarily agreed to being hospitalized. Patients who had been involuntarily committed to the hospital did not show a similar improvement in level of insight into the illness. Furthermore, the low levels of insight persisted throughout the follow up period only in those patients who had been involuntarily admitted to the hospital. Not surprisingly, these same patients were more likely to be involuntarily committed over the course of follow up. The authors conclude that an inability to see oneself as ill seems to be a persistent trait in some patients with schizophrenia and one that leads to involuntary commitment.

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