The contribution of subjective illness representation in explaining impaired insight into illness of people with schizophrenia

Abstract

Background: Findings to explain impaired insight into illness of people with schizophrenia are partially inconsistent. Multifactorial approaches, which may explain these inconsistencies, hardly exist. Objective: Does a typological model and the utilization of a health-psychological approach to illness representations improve clinical insight-models? Methods: We cross-sectionally assessed insight, illness representations, symptoms and neurocognition in 95 persons with diagnoses of schizophrenia. Results: We identified an insightful, cognitively unimpaired subgroup and two subgroups lacking insight (cognitively impaired vs. unimpaired). The latter was multinomially predicted by positive symptoms, subjective treatment control and emotional illness representations (R-N(2)=.56). Conclusions: Including illness representations in clinical insight-models seems to be promising. Beside neurocognitively-based unawareness, different illness representations of subgroups may point to motivational barriers to insight.