Insight in Chinese schizophrenia patients: A 12-month follow-up

Abstract

Insight is a multidimensional concept that is defined as a patient's recognition of having a psychiatric disorder, of the social consequences of that disorder and of the need for treatment. Improving insight is one of the major aims of pharmacotherapy and psychosocial interventions in schizophrenia because it is pivotal in engaging patients in treatment and also has implications for prognosis. Core psychiatric concepts as insight is not independent of the socio-cultural environment, and to date there is no study that explores that relationship between insight and socio-demographic characteristics, psychotic symptoms, depression, executive functions and quality of life in schizophrenia patients in China. Standard psychiatric care does not improve the level of insight in clinically stable Chinese schizophrenia outpatients, which warrants the introduction of specific therapeutic interventions that enhance insight. This study aimed to assess insight in Chinese schizophrenia patients and to identify its relationship with socio-demographic and clinical factors, executive functions and quality of life (QOL). A cohort of 139 clinically stable schizophrenia patients was selected by consecutively screening patients diagnosed with schizophrenia who were attending the outpatient department of a university-affiliated psychiatric hospital in China. Participants' socio-demographic and clinical characteristics, including psychotic symptoms, depression and insight, as well as QOL and executive functions, were periodically assessed with standardized rating instruments. Patients received standard psychiatric care and were followed up for 1 year. Impaired insight was found to be common in stable Chinese schizophrenia patients (76.3%), with merely 5% showing improvement over the 1-year follow-up. Insight was inversely correlated with positive and negative symptoms at all but the 12-month assessment and with both the physical and mental components of QOL at baseline and the 12-month assessment. Insight was not associated with depressive symptoms or executive functions. Standard psychiatric care does not improve the level of insight in clinically stable Chinese schizophrenia outpatients, which warrants the introduction of specific therapeutic interventions that enhance insight. © 2011 Blackwell Publishing.