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CNS Drugs
Erschienen in: CNS Drugs 2/2007

01.02.2007 | Review Article

Lack of Insight in Schizophrenia

Impact on Treatment Adherence

verfasst von: Prof Peter F. Buckley, Donna A. Wirshing, Prameet Bhushan, Joseph M. Pierre, Seth A. Resnick, William C. Wirshing

Erschienen in: CNS Drugs | Ausgabe 2/2007

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Abstract

People with schizophrenia commonly lack insight, that is, they are unaware of their illness and the consequences thereof. One of the most important consequences of lack of insight is a failure to recognise the need for treatment, leading to treatment nonadherence. With several scales that now enable objective measurement of insight, it is possible to examine correlates of insight change, including course of illness and treatment adherence. Specific interventions, both pharmacological and psychotherapeutic, have been developed to enhance illness insight and treatment adherence. The extent to which second-generation antipsychotic medications, including a recently released long-acting formulation, improve insight and/or enhance treatment adherence remains to be determined.
Fußnoten
1
The use of trade names is for product identification purposes only and does not imply endorsement.
 
Literatur
1.
Amador XF, David AS. Insight and schizophrenia. 2nd ed. Cambridge: Oxford University Press, 2004
2.
3.
Cuesta M, Peralta V, Zarzuela A. Reappraising insight in psychosis. Br J Psychiatry 2000; 177: 233–40PubMedCrossRef
4.
Smith BB. First person account: medications are not enough. Schizophr Bull 2003; 29: 139–42PubMedCrossRef
5.
Jablensky A, Sartorius N, Ernberg G, et al. Schizophrenia: manifestations, incidence, and course in different cultures: a World Health Organization 10-country study. Psychol Med Monogr Suppl 1992; 20: 1–97PubMedCrossRef
6.
Amador XF, Flaum M, Andreasen NC, et al. Awareness of illness in schizophrenia and schizoaffective and mood disorders. Arch Gen Psychiatry 1994; 51: 826–36PubMedCrossRef
7.
Ghaemi S, Stoll AL, Pope Jr HE. Lack of insight in bipolar disorder: the acute manic episode. J Nerv Ment Dis 1995; 183(7): 464–7PubMedCrossRef
8.
Pini S, Cassano G, Dell’Osso L, et al. Insight into illness in schizophrenia, schizoaffective disorder, and mood disorders with psychotic features. Am J Psychiatry 2001; 158(1): 122–5PubMedCrossRef
9.
Sipos A, Harrison G, Gunnell D, et al. Patterns and predictors of hospitalization in first-episode psychosis. Br J Psychiatry 2001; 178(6): 518–23PubMedCrossRef
10.
Coldham EL, Addington J, Addington D. Medication adherence of individuals with a first episode of psychosis. Acta Psychiatr Scand 2002; 106(4): 286–90PubMedCrossRef
11.
Mutsatsa SH, Joyce EM, Hutton SB, et al. Clinical correlates of early medication adherence: West London first episode schizophrenia study. Acta Psychiatr Scand 2003; 108(6): 439–46PubMedCrossRef
12.
Smith T, Hull J, Santos L. The relationship between symptoms and insight in schizophrenia: a longitudinal perspective. Schizophr Res 1998; 33: 63–7PubMedCrossRef
13.
Mutsatsa SH, Joyce EM, Hutton SB, et al. Relationship between insight, cognitive function, social function and symptomatology n schizophrenia: the West London first episode study. Eur Arch Psychiatry Neurosci 2006; 256(6): 356–63CrossRef
14.
Crumlish N, Whitty P, Kamali M, et al. Early insight predicts depression and attempted suicide after 4 years in first-episode schizophrenia and schizophreniform disorder. Acta Psychiatr Scand 2005; 112(6): 449–55PubMedCrossRef
15.
Sanz M, Constable G, Lopez-Ibor I, et al. A comparative study of insight scales and their relationship to psychopathological and clinical variables. Psychol Med 1998; 28: 437–46PubMedCrossRef
16.
Amador XF, Johanson AL. I am not sick, I don’t need help. New York: Oxford University Press, 2000
17.
McEvoy JP, Freter S, Everett G, et al. Insight in schizophrenia: its relationship to acute psychopathology. J Nerv Ment Dis 1989; 177: 43–7PubMedCrossRef
18.
McEvoy JP, Freter S, Everett G, et al. Insight and the clinical outcome of schizophrenia patients. J Nerv Ment Dis 1989; 177: 48–51PubMedCrossRef
19.
McEvoy JP, Appelbaum PS, Apperson LJ, et al. Why must some schizophrenic patients be involuntarily committed? The role of insight. Compr Psychiatry 1989; 30: 13–7PubMedCrossRef
20.
David A, Van Os J, Jones P, et al. Insight and psychotic illness: cross-sectional and longitudinal associations. Br J Psychiatry 1995; 167: 621–8PubMedCrossRef
21.
Kraepelin E. Psychiatrie. 4th ed. Lepzig: JA Barth, 1893
22.
McGlashan TH, Levy ST. Sealing-over in a therapeutic community. Psychiatry 1977; 40: 55–65PubMed
23.
Birchwood M, Tait L, Tower P. Predicting engagement with services for psychosis: insight, symptoms and recovery style. Br J Psychiatry 2003; 182: 123–8PubMedCrossRef
24.
McGlashan TH. Recovery styles from mental illness and long-term outcome. J Nerv Ment Dis 1987; 175: 681–5PubMedCrossRef
25.
Birchwood MJ, Mason R, MacMillan F, et al. Depression, demoralization and control over psychotic illness: a comparison f depressed and non-depressed patients with chronic psychosis. Psychol Med 1993; 23: 387–95PubMedCrossRef
26.
Birchwood M, Iqbal Z, Chadwick P, et al. Cognitive approach to depression and suicidal thinking in psychosis: ontogeny of post-psychotic depression. Br J Psychiatry 2000; 177: 516–28PubMedCrossRef
27.
Amador XF, Friedman J, Kasapis C, et al. Suicidal behavior in schizophrenia and its relationship to awareness of illness. Am J Psychiatry 1996; 153(9): 1185–8PubMed
28.
Kim C, Jayathilake K, Meltzer HY, et al. Hopelessness, neurocognitive function, and insight in schizophrenia: relationship to suicidal behavior. Schizophr Res 2003; 60(1): 71–80PubMedCrossRef
29.
Schwartz R. Insight and suicidality in schizophrenia: a replication study. J Nerv Ment Dis 1999; 187: 376–8PubMedCrossRef
30.
Young D, Davila R, Scher H. Unawareness of illness and neuropsychological performance in chronic schizophrenia. Schizophr Res 1993; 10: 117–24PubMedCrossRef
31.
Buckley PF, Hesen S, Friedman L, et al. Insight and schizophrenia. Compr Psychiatry 2001; 42(1): 39–41PubMedCrossRef
32.
Young DA, Zakzanis KK, Bailey C. Further parameters of insight and neuropsychological deficit in schizophrenia and other chronic mental diseases. J Nerv Ment Dis 1998; 186: 44–50PubMedCrossRef
33.
Flashman L, McAllister T, Andreasen N, et al. Smaller brain size associated with unawareness of illness in patients with schizophrenia. Am J Psychiatry 2000; 157: 1167–9PubMedCrossRef
34.
Flashman L, McAllister T, Johnson S, et al. Specific frontal lobe subregions correlated with unawareness of illness in schizophrenia: preliminary study. J Neuropsychiatry Clin Neurosci 2001; 13: 255–7PubMedCrossRef
35.
Lee KH, Brown WH, Egleston PN, et al. A functional magnetic resonance imaging study of social cognition in schizophrenia during an acute episode and after recovery. Am J Psychiatry 2006; 163(11): 1926–33PubMedCrossRef
36.
Pia L, Tamietto M. Unawareness in schizophrenia: neuropsychological and neuroanatomical findings. Psychiatry Clin Neurosci 2006; 60(5): 531–7PubMedCrossRef
37.
Shad MU, Tamminga CA, Cullum M, et al. Insight and frontal cortical function in schizophrenia: a review. Schizophr Res 2006; 86(1–3): 54–70PubMedCrossRef
38.
Aleman A, Agrawal N, Morgan KD, et al. Insight in psychosis and neuropsychological function: meta-analysis. Br J Psychiatry 2006; 189; 204–12PubMedCrossRef
39.
Marks KA, Fastenau PS, Lysaker PH, et al. Self-appraisal of illness questionnaire: neuropsychological validation in schizophrenia. lin Neuropsychol 1999; 13: 218–26
40.
Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997; 23(4): 637–51PubMedCrossRef
41.
Lacro JP, Dunn LB, Dolder CR, et al. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: comprehensive review of recent literature. J Clin Psychiatry 2002; 63(10): 892–909PubMedCrossRef
42.
Kurtz SM. Adherence to diabetic regimens: empirical status and clinical applications. Diabetes Educ 1990; 16: 50–9PubMedCrossRef
43.
Clark LT. Improving compliance and increasing control of hypertension: needs of special hypertensive populations. Am Heart J 1991; 121: 664–9PubMedCrossRef
44.
Dekker FW, Dieleman FE, Kaptein FE, et al. Compliance with pulmonary medication in general practice. Eur Respir J 1993; 6: 886–90PubMed
45.
Van Putten T. Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry 1974; 31(1): 67–72PubMedCrossRef
46.
Van Putten T. Drug refusal in schizophrenia and the wish to be crazy. Arch Gen Psychiatry 1976; 33: 1443–6PubMedCrossRef
47.
Awad AG, Hogan TP, Voruganti LN, et al. Patients’ subjective experiences on antipsychotic medications: implications for outcome and quality of life. Int Clin Psychopharmacol 1995; 10Suppl. 3: 123–32PubMed
48.
Day JC, Bentall RP, Roberts C, et al. Attitudes toward antipsychotic medication: the impact of clinical variables and relationships with health professionals. Arch Gen Psychiatry 2005; 62(7): 717–24PubMedCrossRef
49.
Fruedenreich O, Cather C, Evins AE, et al. Attitudes of schizophrenia outpatients toward psychiatric medications: relationship to clinical variables and insight. J Clin Psychiatry 2004; 65(10): 1372–6CrossRef
50.
Hofer A, Kemmler G, Eder U, et al. Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry 2004; 65(7): 932–9PubMedCrossRef
51.
Van Putten T, May R. “Akinetic depression” in schizophrenia. Arch Gen Psychiatry 1978; 35(9): 1101–7PubMedCrossRef
52.
Glazer WM, Kane JM. Depot neuroleptic therapy: an underutilized treatment option. J Clin Psychiatr 1992; 53(12): 423–33
53.
Adams CE, Fenton MK, Quraishi S, et al. Systematic meta-review of depot antipsychotic drugs for people with schizophrenia. Br J Psychiatry 2001; 179: 290–9PubMedCrossRef
54.
Voruganti L, Cortese L, Oyewumi L, et al. Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, side-effect profile and impact on quality of life. Schizophr Res 2000; 43: 135–45PubMedCrossRef
55.
Wirshing DA. The evolving side effects profile of atypical antipsychotic medications. Psychiatr Clin North Am 2003; 26: 165–90PubMedCrossRef
56.
Wirshing DA, Pierre JM, Marder SR, et al. Sexual side effects of novel antipsychotic medications. Schizophr Res 2002; 56(1–2): 25–30PubMedCrossRef
57.
Dolder CR, Lacro JP, Dunn LB, et al. Antipsychotic medication adherence: is there a difference between typical and atypical agents? [published erratum appears in Am J Psychiatry 2002; 159(3): 514]. Am J Psychiatry 2002; 159(1): 103–8PubMedCrossRef
58.
Valenstein M, Copeland LA, Blow FC, et al. Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care 2002; 40(8): 630–9PubMedCrossRef
59.
Kane JM, Keith SJ, Eerdekens M. Treatment of schizophrenia with long-acting injectable risperidone. Am J Psychiatry 2003; 160: 1125–32PubMedCrossRef
60.
Csernansky JG, Mahmoud R, Brenner R. A comparison risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. N Engl J Med 2002; 346: 16–22PubMedCrossRef
61.
Fleishacker WW, Eerdekens M, Karcher K, et al. Treatment of schizophrenia with longacting, injectable risperidone: a 12-month open labelled trial of the first longacting second generation antipsychotic. J Clin Psychiatry 2003; 64: 1250–7CrossRef
62.
Gharabawi GM, Lasser RA, Bossie CA, et al. Insight and its relationship to clinical outcomes in patients with schizophrenia or schizoaffective disorder receiving long-acting risperidone. Int Clin Psychopharmacol 2006; 21(4): 233–40PubMedCrossRef
63.
64.
Siegel SJ, Winey KI, Gur RE, et al. Surgically implantable long-term antipsychotic delivery systems for the treatment of schizophrenia. Neuropsychopharmacology 2002; 26(6): 817–23PubMedCrossRef
65.
Zygmunt A, Olfson M, Boyer CA, et al. Interventions to improve medication adherence in schizophrenia. Am J Psychiatry 2002; 159: 1653–64PubMedCrossRef
66.
Heinssen RK. Improving medication compliance of a patient with schizophrenia through collaborative behavioral therapy. Psychiatr Serv 2002; 53: 255–7PubMedCrossRef
67.
Kemp R, Kirov G, Hayward P, et al. Compliance therapy in psychotic patients: randomized controlled trial. BMJ 1996; 372: 345–9CrossRef
68.
Kemp R, Kirov G, Everitt B, et al. Randomized controlled trial of compliance therapy. 18-month follow-up. Br J Psychiatry 1998; 172: 413–9
69.
Rusch N, Corrigan PW. Motivational interviewing to improve insight and treatment adherence in schizophrenia. Psychiatr Rehabil J 2002; 26(1): 23–32PubMedCrossRef
70.
O’Donnell C, Donohoe G, Sharkey L, et al. Compliance therapy: a randomized control trial in schizophrenia. BMJ 2003; 11: 834CrossRef
71.
Byerly MJ, Fisher R, Carmody T, et al. A trial of compliance therapy in outpatients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 2005; 66(8): 997–1001PubMedCrossRef
72.
Turkington D, Weiden P. Cognitive behavioral therapy for schizophrenia. Am J Psychiatry 2006; 163(3): 365–73PubMedCrossRef
73.
Liberman RP, Wallace CJ, Blackwell G, et al. Skills training versus psychosocial occupational therapy for persons with persistent schizophrenia. Am J Psychiatry 1998; 155(8): 1087–91PubMed
74.
Weiden PJ. Promoting compliance in schizophrenia: one month at a time. Current Psychiatry 2002; 1: 74
75.
Weiden PJ, Miller AL. Which side effects really matter? Screening for common and distressing side effects of antipsychotic medications. J Psychiatr Prac 2001; 7: 41–7CrossRef
76.
Torrey EF. Surviving schizophrenia: a manual for families, consumers and providers. 4th ed. New York (NY): Harper Collins, 2002
77.
78.
Sajatovic M, Sultana D, Buckley P, et al. Insight into illness and attitudes towards medication inpatients with schizophrenia. Psychiatr Serv 2002; 53: 319–1321CrossRef
79.
Cournos F, McKinnon K, Stanley B. Outcome of involuntary medication in a state hospital system. Am J Psychiatry 1991; 148(4): 489–94PubMed
80.
Aguglia E, De Vanna M, Onor ML, et al. Insight in persons with schizophrenia: effects of switching from conventional neuroleptics to atypical antipsychotics. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26(7–8): 229–33
81.
Rittmannsberger H, Pachinger T, Keppelmuller P, et al. Medication adherence among patients before admission to inpatient treatment. Psychiatr Serv 2004; 55(2): 74–9CrossRef
82.
Wirshing DA, Marder SR, Wirshing WC. Subjective response to atypical antipsychotic medications. International Congress on Schizophrenia Research; 1999 April 17–21; Santa Fe. Schizophr Res 1999; 36 (1–3): 302
83.
Green MF, Marshall BD, Wirshing WC, et al. Does risperidone improve verbal working memory in treatment resistant schizophrenia? Am J Psychiatry 1997; 154(6): 799–804PubMed
84.
Green MF, Marder SR, Glynn SM, et al. The neurocognitive effects of low dose haloperidol: a two-year comparison with risperidone. Biol Psychiatry 2002; 51(2): 972–8PubMedCrossRef
85.
Jeste SD, Patterson JL, Palmer BW, et al. Cognitive predictors of medication adherence among middle-aged and older outpatients with schizophrenia. Schizophr Res 2003; 63(1–2): 49–58PubMedCrossRef
86.
Macpherson R, Jerrom B, Hughes A. A controlled study of education about drug treatment in schizophrenia. Br J Psychiatry 1996; 168(6): 709–17PubMedCrossRef
87.
Macpherson R, Jerrom B, Hughes A. Relationship between insight, educational background and cognition in schizophrenia. Br J Psychiatry 1996; 168(6): 718–22PubMedCrossRef
88.
Rossotto E, Wirshing DA, Liberman RP. Rehab rounds: enhancing adherence to treatment in patients with schizophrenia by eaching community re-entry skills. Psychiatr Serv 2004; 55(1): 26–7PubMedCrossRef
89.
Kemp R, David A. Psychological predictors of insight and compliance in psychotic patients. Br J Psychiatry 1996; 169(4): 444–50PubMedCrossRef
90.
Newcomer JH. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs 2005; 19Suppl. 1: 1–93PubMed
91.
Lieberman JA, Stroup S, McEvoy J, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353(12): 1209–23PubMedCrossRef
92.
Buckley PF. Which drug should I choose next: guidance from the phase II results of CATIE. Curr Psychiatry 2006; 5: 27–43
Metadaten
Titel
Lack of Insight in Schizophrenia
Impact on Treatment Adherence
verfasst von
Prof Peter F. Buckley
Donna A. Wirshing
Prameet Bhushan
Joseph M. Pierre
Seth A. Resnick
William C. Wirshing
Publikationsdatum
01.02.2007
Verlag
Springer International Publishing
Erschienen in
CNS Drugs / Ausgabe 2/2007
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200721020-00004

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