South African Medical Journal

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The relationship between insight and psychosis in state patients with schizophrenia

L.H. Steytier, C.A. Gagiano, G. Joubert


Objective. State patients committed under the Mental Health Act must have insight  into their illness and the crime they committed before they can be discharged.  Patients with schizophrenia are described as having poor insight into the nature and severity of their disorder. Various factors influence insight, and in some studies level of insight seems to correlate with level of psychopathology. In this study insight was measured in State patients with schizophrenia and re-evaluated after 2 months. Level of insight was compared with level of psychopathology.
Method. 34 patients with schizophrenia were evaluated twice to determine their level of insight and psychopathology. The following factors were considered: duration of hospitalisation, duration of illness, age of onset of illness, and level of functioning before admission.
Results. Insight improved slightly over the 2-month period, showing weak  correlation with psychopathology. Negative insight, insight regarding mental illness and the use of medication, and attribution of past illness were good.
Conclusion. Insight should be viewed as being multidimensional, with various factors influencir!g it. Level of insight plays an important role in the treatment programme of patients with schizophrenia.

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