Zsolt Juhász Levente, György Bartkó
I. Pszichiátriai és Pszichiátriai Rehabilitációs Osztály.
Psychiatr Hung. 2006;21(6):413-21.
Poor insight into illness is a characteristic and common phenomenon in schizophrenic disorders. Lack of insight may lead to poor clinical outcome, thus, research focused on this phenomenon could help develop effective treatment strategies. The relationship between compliance with treatment and insight is complex and it may be influenced mostly by specific components of insight. The aim of the present study was to review the current definitions of insight, the tools and questionnaires used for its measurement, as well as the relationship between insight and psychopathological symptoms. Three theoretical models developed for the explanation of impaired insight are described; the Psychological Defence Model, the Cognitive Deficit Model, and the Neuropsychological Deficit Model. The neurocognitive bases of impaired insight is given special attention in this article. Administration of second generation antipsychotics and psychosocial interventions (psychoeducation with problem solving procedures and motivating techniques) can improve insight, and enhance compliance with treatment, thus, optimizing long-term therapeutic outcome for schizophrenia patients.
对疾病缺乏洞察力是精神分裂症谱系障碍的一个典型且常见的现象。缺乏洞察力可能导致临床预后不良，因此，针对这一现象的研究有助于制定有效的治疗策略。治疗依从性与洞察力之间的关系较为复杂，且可能主要受洞察力特定成分的影响。本研究的目的是综述洞察力的当前定义、用于测量洞察力的工具和问卷，以及洞察力与精神病理症状之间的关系。文中描述了为解释洞察力受损而提出的三种理论模型：心理防御模型、认知缺陷模型和神经心理缺陷模型。本文特别关注了洞察力受损的神经认知基础。使用第二代抗精神病药物以及心理社会干预措施（采用解决问题程序和激励技术的心理教育）可以改善洞察力，并提高治疗依从性，从而优化精神分裂症患者的长期治疗效果。
