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Relationship Between Insight, Educational Background and Cognition in Schizophrenia

Published online by Cambridge University Press:  02 January 2018

Rob Macpherson ,
Bill Jerrom  and
Anthony Hughes
Rob Macpherson*
Affiliation:
Wotton Lawn, Gloucester
Bill Jerrom
Affiliation:
Long Fox Unit, Weston General Hospital, Weston-super-Mare, Avon BS23 4TQ
Anthony Hughes
Affiliation:
Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR
*
Dr R. Macpherson, Wotton Lawn, Horton Road, Gloucester GL1 3PX
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Abstract

Background

There is a paucity of research into the relationship between insight and variables including cognitive function, educational background and symptomatology in schizophrenia.

Method

Sixty-four patients with DSM–III–R diagnosis schizophrenia were assessed with the Schedule for Assessment of Insight, Mini Mental State cognitive test, a new measure of knowledge about treatment (the Understanding of Medication Questionnaire), and educational background and compliance assessments.

Results

Insight scores correlated significantly with a range of variables. In a multiple regression analysis only knowledge about treatment and number of years in education explained a significant proportion of insight.

Conclusion

Educational background and the intellectual ability required to learn complex concepts, such as models of mental illness, appear to be more important than previously considered. Research is limited by the lack of a generally accepted definition of insight.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 6 , June 1996 , pp. 718 - 722
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Amador, S. F., Strauss, D. H., Yale, S. A., et al (1991) Awareness of illness in schizophrenia. Schizophrenia Bulletin, 17, 113–132.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Barter, J. T. (1984) Psychoeducation. In The Chronic Mental Patient (ed. Talbot, J. A.), pp. 183–191. New York: Grune & Stratton.Google Scholar
Bazire, S. (1994) Psychotropic Drug Directory. London: Gaskell.Google Scholar
Benson, P. R. (1984) Informed consent: drug information disclosed to patients prescribed antipsychotics. Journal of Nervous and Mental Diseases, 173, 652–653.Google Scholar
Birchwood, M. & Macmillan, F. (1993) Early intervention in schizophrenia. Australian and New Zealand Journal of Psychiatry, 27, 374–378.Google Scholar
Birchwood, M. Smith, J., Drury, V., et al (1993) A self-report insight scale for psychosis: reliability, validity and sensitivity to change. Acta Psychiatrica Scandinavica, 86, 1–6.Google Scholar
Boczkowski, J. A., Zeichner, A. & Desanto, N. (1985) Neuroleptic compliance among chronic schizophrenic out-patients: An intervention outcome report Journal of Consulting and Clinical Psychology, 53, 666–671.CrossRefGoogle ScholarPubMed
Cuesta, M. J. & Peralta, V. (1994) Lack of insight in schizophrenia. Schizophrenia Bulletin, 20, 359–361.Google Scholar
David, A. S. (1990) Insight and psychosis. British Journal of Psychiatry, 161, 253–256.Google Scholar
David, A. S., Buchanan, A., Reed, A., et al (1992) The assessment of insight in psychosis. British Journal of Psychiatry, 161, 599–602.Google Scholar
Eckman, T. A., Liberman, R. P., Phipps, C. C., et al (1990) Teaching medication management skills to schizophrenics. Journal of Clinical Psychopharmacology, 10, 33–38.Google Scholar
Eckman, T. A., Wirshing, M. D., Marder, S. R., et al (1992) Techniques for training schizophrenics in medication management skills. American Journal of Psychiatry, 149, 1549–1555.Google Scholar
Folstein, M. D., Folstein, S. E. & McHugh, P. R. (1975) “Mini Mental State”. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Ganguli, R. & Raghu, U. (1985) Tardive dyskinesia, impaired recall and informed consent. Journal of Clinical Psychology, 46, 434–435.Google Scholar
Geller, J. L. (1982) State hospital patients and their medication – do they know what they take? American Journal of Psychiatry, 134, 287–289.Google Scholar
Glick, I. D., Burti, L., Okonozi, K., et al (1994) Effectiveness in psychiatric care. Psychoeducation and outcome for patients with major affective disorders and their families. British Journal of Psychiatry, 164, 104–106.CrossRefGoogle ScholarPubMed
Goldberg, T. E. & Weinberger, D. R. (1988) Probing prefrontal function in schizophrenia with neuropsychological paradigms. Archives of General Psychiatry, 43, 114–124.Google Scholar
Goodman, C. R. & Quinn, F. L. (1988) Effects of a patient education program in the treatment of schizophrenia. Hospital and Community Psychiatry, 39, 282–286.Google Scholar
Grossman, J. D. & Summers, F. (1980) A study of the capacity of schizophrenic patients to give informed consent. Hospital and Community Psychiatry, 31, 205–206.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual for Psychopathology. Washington, DC: US Department of Health, Education and Welfare.Google Scholar
Helman, C. G. (1981) Disease versus illness in general practice. Journal of the Royal College of General Practitioners, 31, 548–552.Google ScholarPubMed
Helmsley, D. R. (1992) Cognitive abnormalities and schizophrenic symptoms. Psychological Medicine, 22, 839–842.Google Scholar
Irwin, M. (1985) Psychotic patients understanding of informed consent. American Journal of Psychiatry, 142, 1351–1354.Google Scholar
Jaffe, R. (1981) Informed consent: Recall about tardive dyskinesia. Comprehensive Psychiatry, 22, 434–437.CrossRefGoogle ScholarPubMed
Jones, R., Guth, L., Lewis, S., et al (1994) Low intelligence and poor educational achievement precede early onset psychosis. In The Neuropsychology of Schizophrenia (eds David, A. S. & Cathy, J. C.), pp. 131–144. Hove: Lawrence Erlbaum Associates.Google Scholar
Kay, S. R., Fizbein, A. & Opler, L. A. (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–276.Google Scholar
Kay, S. R., & Sevy, S. (1990) Pyramidal model of schizophrenia. Schizophrenia Bulletin, 13, 261–276.CrossRefGoogle Scholar
Kleinman, I., Schachter, D., Korisar, E. (1989) Informed consent and tardive dyskinesia. American Journal of Psychiatry, 146, 902–904.Google ScholarPubMed
Lewis, A. (1935) The psychopathology of insight. Psychiatry, 2, 47–61.Google Scholar
Lysaker, P. & Bell, M. (1994) Insight and cognitive impairment in schizophrenia. Journal of Nervous and Mental Disorders, 182, 656–660.Google Scholar
Macpherson, R. (1995) A Controlled Study of Patient Education in Schizophrenia. M.D. Thesis, University of Bristol.Google Scholar
Macpherson, R., Double, D. B., Rowlands, P. R., et al (1993) Long term psychiatric patients' understanding of neuroleptic medication. Hospital and Community Psychiatry, 44, 71–73.Google ScholarPubMed
McDonald-Scott, P., Machigan, S. & Sotch, H. (1992) Diagnostic disclosure: A tale in two cultures. Psychological Medicine, 22, 147–157.CrossRefGoogle ScholarPubMed
McEvoy, J., Apperson, J., Appelbaum, P. S., et al (1989) Insight in schizophrenia – its relationship to acute psychopathology. Journal of Nervous and Mental Diseases, 177, 43–47.Google Scholar
Munetz, M. R. & Roth, L. H. (1985) Informing patients about tardive dyskinesia. Archives of General Psychiatry, 42, 866–871.Google Scholar
Nelson, H. E. & O'Connell, A. (1978) Dementia: the estimation of premorbid intelligence levels using the National Adult Reading Test. Cortex, 14, 234–244.Google Scholar
Norusis, M. J. (1988) SPSS/PC. Chicago: SPSS Inc.Google Scholar
Royal College of Psychiatrists (1982) Consent to psychiatric treatment for informal patients: College advice to psychiatrists. Bulletin of the Royal College of Psychiatrists, 9, 228.Google Scholar
Schooler, N. R. & Kane, J. M. (1982) Research diagnoses for tardive dyskinesia. Archives of General Psychiatry, 39, 486–487.Google Scholar
Seltzer, A., Runcari, I. & Garfinkel, P. (1980) Effect of patient education on medication compliance. Canadian Journal of Psychiatry, 25, 638–645.Google Scholar
Smith, J. V. & Birchwood, M. (1990) Specific and non-specific effects of educational intervention with families living with a schizophrenic patient. British Journal of Psychiatry, 150, 645–652.Google Scholar
Soskis, D. A. & Jaffe, R. L. (1979) Communicating with patients about antipsychotic drugs. Comprehensive Psychiatry, 20, 126–131.CrossRefGoogle ScholarPubMed
Sullwold, L. & Herrlich, J. (1992) Providing psychiatric patients with a concept of illness. An essential element of therapy. British Journal of Psychiatry, 161 (suppl.), 129–132.Google Scholar
Tarrier, N. & Barrowclough, C. (1986) Providing information to relatives about schizophrenia: some comments. British Journal of Psychiatry, 149, 458–463.Google Scholar
Van Putten, T. V. (1974) Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry, 31, 67–72.Google Scholar
Weiden, P., Rapkin, B., Mott, J., et al (1994) Rating of Medication Influences (ROMI), Scale in Schizophrenia. Schizophrenia Bulletin, 20, 297–307.Google Scholar
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