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Neurocognitive basis of insight in schizophrenia

Department of Psychiatry, St John’s Medical College Hospital, Bangalore, India

RANDOLPH W. PARKS, PhD PsyD, KWANG-HYUK LEE, PhD, RAJINDER S. BHAKER, PAUL BIRKETT, MD, MRCPsych and PETER W. R. WOODRUFF, PhD, FRCPsych

Academic Clinical Psychiatry and SCANLab, University of Sheffield, Sheffield, UK

Correspondence: Correspondence: Professor Peter W. R. Woodruff, Academic Clinical Psychiatry, University of Sheffield, Longley Centre, Norwood Grange Drive, Sheffield S5 7JT, UK. E-mail: p.w.woodruff{at}sheffield.ac.uk

Declaration of interest None.

People with schizophrenia have been categorised into three groups: those with full insight (aware, correct attributers); those aware of being unwell, but who misattributed their symptoms (aware, incorrect attributers); and those unaware of being ill (unaware). Cluster analysis of ‘awareness of illness’and ‘relabelling of symptoms’scores on the Schedule for the Assessment of Insight confirmed three distinct subgroups. The unaware group were impaired on executive and memory tests, whereas those in the aware, misattributing group were cognitively intact. Findings support an association between unawareness of illness and executive dysfunction, and highlight the separation of symptom misattribution from unawareness of illness.