Insight in schizophrenia and its relationship to psychopathology.

A group of 29 patients with DSM-IIIR schizophrenia was studied during acute hospital admission to examine the relationship between changes in insight and positive and negative symptomatology in schizophrenia. On admission, insight scores were obtained using a modification of the SUMD (Amador et al., 1993), and of the degree of psychopathology using the PANSS (Kay et al., 1987). These measures were repeated prior to discharge between 3 and 6 weeks later. Insight improved significantly during the course of in-patient treatment. A relationship between psychopathology and insight level was evident at both assessments, though the pattern was different. Improvement in psychopathology correlated significantly with increased insight into past symptoms but not current illness. When treatment responders were examined there was a significant relationship only with negative symptom improvement and PANSS totals, but not with improvement in positive symptoms. The greater the trend towards negative symptom predominance, the less the tendency to improve in the awareness of current symptoms. This study suggests an inverse relationship with enduring negative symptoms.