Many people being treated for mental illnesses feel slightly more depressed and much less satisfied with their lives if they have greater “insight” into their illnesses, according to a study in Schizophrenia Research. “Insight” was defined by the authors as being related to acknowledgement of one’s illness along with “treatment adherence” and “treatment engagement.”
The researchers noted that previous research has been contradictory as to whether having “insight” into one’s “mental illness” along with “treatment adherence” and “treatment engagement” are actually helpful to people or not. “A frequently proposed key condition for recovery is insight into the illness, defined as awareness of the phenomena and consequences derived from having a mental disorder,” wrote the researchers. Lack of such insight or denial that one actually has a mental illness, they added, “is one of the major defining characteristics of psychosis and a frequently observed aspect in persons suffering from schizophrenia spectrum disorders.”
The researchers noted that some studies have found “lower levels of insight” related to increased symptomatology and severity, poor psychosocial adjustment, poor social and vocational functioning, low treatment adherence and negative prognosis. Other studies, however, have found that “higher levels” of such “insight” are connected with increased hopelessness and emotional distress, depressed mood and lower self-esteem, lower subjective quality of life, higher suicide risk, lower physical health and vitality, lower vocational status and less economic satisfaction.
Led by researchers from the University of Madrid in Spain, the 47 participants in this study were a convenience sample of inpatients of psychiatric units in two university hospitals who were currently suffering from “persecutory beliefs” and had diagnoses related to schizophrenia, psychosis and delusional disorders. All of them were currently involved in psychiatric treatment, and were interviewed by the researchers.
The researchers found that as “insight” into one’s “mental illness” decreased, the patients experienced less anxiety. “This could suggest that accepting the illness was associated with uneasiness and not to relieve (sic) in these cases,” the researchers wrote. They also found a “positive and significant association” between “poor insight” and satisfaction with life, “suggesting that acceptance of the illness is associated with dissatisfaction.” They further found that, “The presence of insight was associated with more depression when there were high levels of self-stigma.”
Valiente, Carmen, Maria Provencio, Regina Espinosa, Almudena Duque, and Franziska Everts. “Insight in Paranoia: The Role of Experiential Avoidance and Internalized Stigma.” Schizophrenia Research 0, no. 0. Accessed April 12, 2015. doi:10.1016/j.schres.2015.03.010. (Abstract)