Insight and Recovery in Schizophrenia: an Observational Study

Introduction Definitions of therapeutic outcome in schizophrenia include both maintained symptomatic remission and appropriate functioning. In schizophrenic patients insight is associated with positive (better compliance and recovery) and negative outcomes (depression, low self-esteem and quality of life). Objectives To evaluate the correlation between insight and recovery in schizophrenic patients according to criteria for both symptomatic and functional remission. Aims To demonstrate how high levels of insight are positively correlated with recovery. Methods 70 schizophrenic patients who switched or started a new pharmacological treatment were tested using Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Short Form questionnaire, Psychological General Well-Being Index and Global Assessment of Functioning scale at baseline, 12 and 24 months. Results After 2 years, 50% of the subjects achieved symptom remission and 25.5% had adequate social functioning for 2 years or more. Only 12% of subjects met full recovery criteria for 2 years or longer. Patients in remission showed a better outcome on all PANSS subscales, an improvement in social functioning and in subjective well-being. No differences in terms of Quality of life between groups. All patients in recovery showed an improvement of insight, especially those treated with SGA. Recovery after 2 years was predicted by female sex, higher age, pre-morbid social adaptation and low level of negative symptoms at baseline. Conclusions The results indicate that only 12% of patients achieve recovery and suggest that social functioning, compliance, type of antipsychotic and improvement in insight levels represent important predictors for recovery.