Evaluation of insight and comparison of different insight scales in patients with schizophrenia

INTRODUCTION AND OBJECTIVE: Insight is a key feature in the psychosis clinic; it is generally defined as awareness of the disease and compliance with treatment; but its scope, limits and form of measurement are controversial. Many scales with different definitions and conceptual bases have been developed. In our study, we aimed to examine the similarities and differences of these scales and their predictive power of disease symptoms by using different insight scales in patients with schizophrenia in remission. METHODS: The study was carried out on patients aged 18-65 years, who applied to Sakarya University Training and Research Hospital Psychiatry outpatient clinic and Community Mental Health Center, were diagnosed with schizophrenia according to DSM-5 criteria, completed acute treatment, and continued on maintenance treatment. 105 cases who accepted to participate in this study and met the study's inclusion and exclusion criteria were included. DSM-V-adapted SCID-1 interview was conducted to confirm the diagnosis of schizophrenia and to evaluate comorbid psychiatric disorders. Afterward, the Positive and Negative Syndrome Scale (PANNS) and the insight scales which are the Beck Cognitive Insight Scale, Brown Assessment of Beliefs Scale, Scale for Assessing the Three Components of Insight, The Scale of Unawareness of Mental Disorders, and Expressed Emotions Scale were used to assess the severity of the disease. RESULTS: All insight scales were found to be negatively correlated with symptom severity in patients with schizophrenia in remission. The scale that best predicted the total symptom level of PANNS was the ADVD, and the second predictive value was IUB Insight. The scale that best-predicted PANNS positive symptom level was found to be ADVD. The scale that best-predicted PANNS negative symptom level was IUB and the second predictive value was ADVD. The scale that best predicted the general symptom level of PANNS was BROWN. CONCLUSION: Although insight scales were highly correlated with each other and with schizophrenia symptoms. However, insight scales differed in predicting different symptom subgroups of schizophrenia; best predicted positive symptoms of ADVD, negative symptoms of IUD and general psychopathology of BROWN. Keywords: Insight, insight scales, positive and negative symptom scales, symptom severity, schizophrenia