Is lack of insight associated with physically aggressive behavior among people with schizophrenia living in the community?

It is presently not known if lack of insight is related to physically aggressive behavior toward others among persons with schizophrenia, after controlling for known predictors such as psychopathy traits, and positive symptoms. Patients with schizophrenia (n = 209) were followed for 2 years after discharge. At discharge, psychopathy traits, insight and symptoms were assessed. At the beginning of each six-month period, insight and symptoms were assessed, whereas aggressive behavior, reported by patients and collateral informants, was assessed at the end of each period. Lack of insight was associated with aggressive behavior in univariate analyses but did not contribute to the prediction of aggressive behavior once scores for psychopathy and positive symptoms were entered into the model. The results demonstrate that among individuals with schizophrenia, aggressive behavior was more strongly associated with high scores for psychopathy traits and positive symptoms than with lack of insight.