Insight in Patients of Schizophrenia

Introduction Insight is defined as the capacity to gain an accurate and deep understanding of things, in psychiatry, insight refers to awareness of aspects of oneself. Lack of insight was found to be almost invariably associated with a diagnosis of acute schizophrenia. Previous studies estimate that between 50-80 % of patients with schizophrenia do not believe they have a disorder. Present study thus aimed to assess insight in patients with schizophrenia and their treatment outcome. Materials& Methods A Prospective Observational study was conducted at Department of Psychiatry of a tertiary care hospital. Consecutive type of non-probability sampling was used and a total of 50 diagnosed cases (DSM V criteria) of schizophrenia fulfilling the eligibility criteria were taken for study after informed consent. Both a self-report scale Birchwood Insight Scale and semi-structured interview Insight and Treatment Attitude Questionnaire (ITAQ) used to assess insight in schizophrenic patients. Severity of schizophrenia was rated using semi-structured scale (PANSS Scale). Assessments was done at baseline and repeated after 6 weeks with treatment for schizophrenia Results Lack of insight was observed in about 44 % patients. Increased duration of symptoms correlates significantly with lack of Insight (pless than0.05). Symptoms of Schizophrenia i. e. positive, negative and general all correlates inversely with insight i. e. increased severity of symptoms causes decrease in patients insight (pless than0.05). Insight of patients improved significantly following treatment in cases of schizophrenia as observed by mean increase in both objective and subjective insight scale scores (pless than0.05). Change in Positive and general symptoms of schizophrenia both correlated significantly with change in insight post-treatment, which shows that improvement in symptoms of schizophrenia leads to improvement in insight. Conclusion Poor insight is common in schizophrenia with approximately half of all patients exhibiting lack of insight. There appears to be a clear association between insight and treatment during active phase of illness. Insight also correlates with improvement in symptoms following anti-psychotic therapy.