Awareness of Illness in Schizophrenia and Outpatient Treatment Adherence

Abstract

We present a brief measure of awareness of illness in schizophrenia and test whether awareness is related to perceived need for and adherence to outpatient psychiatric treatment. A prospective design assessed treatment adherence, awareness of the signs and symptoms of schizophrenia, symptoms, neurocognitive status, and substance abuse at baseline and 6-month follow-up in 89 persons with schizophrenia. Results indicate that persons with greater awareness perceived greater need for outpatient treatment and evidenced better adherence to outpatient treatment when adherence and awareness were measured concurrently. Awareness was not related to adherence at 6-month follow-up. In addition, neurocognitive impairment was associated with lower overall adherence to treatment when reported by collaterals at baseline and 6-month follow-up. Neurocognitive impairment was, however, associated with higher self-reported adherence to medication, which suggests that neurocognitive status may bias adherence reporting in persons with schizophrenia.

The role of insight in the process of recovery from schizophrenia: A review of three views

“…Indeed, this is implicitly the goal of a range of psychoeducational programs (Rummel-Kluge & Kissling, 2008). Supporting this view are cross-sectional studies that have found insight was associated with treatment adherence (Bollini, Tibaldi, Testa, & Munizza, 2004;Cuffel, Alford, Fischer, & Owen, 1996), reduced length of hospitalization, decreased relapse, and lower rehospitalization rates (Leo, Jassal & Bakhai, 2005). Reviewed by Lincoln and colleagues (2007), other longitudinal studies have found that insight was positively associated with improvements in functioning over time (Lincoln et al 2007).…”

Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem

“…Factors that contribute to poor awareness of cognitive problems are: gender (Cuffel et al 1996; Mintz et al 2003), age of onset (Lysaker & Bell, 1995) and lower education levels (Macpherson et al 1996; Ritsner & Blumenkrantz, 2007), but the evidence is not conclusive (e.g. David et al 1995; Goldberg et al 2001).…”

Subjective Response to Antipsychotics of Schizophrenia Patients Treated in Routine Clinical Practice

“…25 The vast majority of literature indicated that higher levels of insight correlated with positive subjective response to antipsychotics, 14 better medication compliance, 26,27 improved functioning and social adjustment, 28,29 and clinical and treatment outcomes. 30-33 A 16-month follow-up study of 148 schizophrenia patients showed that as awareness of the need for treatment increased, scores of satisfaction with medication also increased.…”