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17-01-2012 | Mental health | Article

Poor insight linked to increased QoL in Chinese schizophrenia patients


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MedWire News: Poor illness insight is associated with increased physical quality of life (QoL), but also greater negative symptom severity, in Chinese patients with schizophrenia, study results suggest.

"The concept of insight has long been considered important in psychiatry because of its impact on treatment and prognosis," observe Chuan-Yue Wang (Capital Medical University, Beijing, China) and team in Comprehensive Psychiatry.

However, they explain that most previous studies examining insight and its association with symptoms and QoL in schizophrenia patients have been conducted among Western populations and have produced conflicting results.

"To date, there has been no study published in China that explores the relationship of insight with sociodemographic and clinical variables, neuropsychologic impairment, and QoL in schizophrenia," they add.

To address this, the researchers studied 139 Chinese patients, aged 16-50 years (mean age 33.4 years), with clinically stable schizophrenia who had an illness duration of 5 years or less.

All of the patients were assessed for insight using the 11-item Insight and Treatment Attitudes Questionnaire (ITAQ), with a total score of 15 or higher indicating good insight and lower scores indicating poor insight.

They were also assessed for symptom severity using the Chinese version of the Positive and Negative Syndrome Scale (PANSS), the presence and severity of depressive symptoms using the Montgomery-Åsberg Depression Rating Scale (MADRS), and social functioning using the Chinese version of the Social Disability Screening Schedule (SDSS). Quality of life was evaluated using the Chinese version of the Medical Outcome Study 36-Item Short Form questionnaire (SF-36).

The researchers found that the mean total score on the ITAQ was 9.7. Only 23.7% of patients had an ITAQ score of 15 or higher, with the remaining 76.3% having poor insight.

Univariate analysis revealed that poor insight was associated with increased positive, negative, and general symptom scores on the PANSS, and higher scores for physical and mental QoL on the SF-36, compared with good insight.

Stepwise multiple linear regression analysis, which controlled for factors such as age, gender, education, age at onset, duration of illness, and use of first-and second-generation antipsychotics, indicated that poor insight was independently associated with greater negative symptom severity, a shorter illness duration, and higher scores for physical QoL, compared with good insight.

Wang and colleagues conclude: "Good insight is frequently associated with a low QoL and the current study confirmed this association in Chinese patients with schizophrenia."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Mark Cowen

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