title: Insight and subjective measures of quality of life in chronic schizophrenia.
abstract: Lack of insight is a well-established phenomenon in schizophrenia, and has been associated with reduced rater-assessed functional performance but increased self-reported well-being in previous studies. The objective of this study was to examine factors that might influence insight (as assessed by the Insight and Treatment Attitudes Questionnaire [ITAQ] or PANSS item G12) and subjective quality-of-life (as assessed by Lehman QoL Interview [LQOLI]), using the large National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset. Uncooperativeness was assessed by PANSS item G8 ("Uncooperativeness"). In the analysis, we found significant moderating effects for insight on the relationships of subjective life satisfaction assessment to symptom severity (as assessed by CGI-S score), objective everyday functioning (as assessed by rater-administered Heinrichs-Carpenter Quality of Life scale), clinically rated uncooperativeness (as assessed by PANSS G8), and discontinuation of treatment for all causes (all P > 0.05 for statistical interaction between insight and subject QoL). Patients with chronic schizophrenia who reported being "pleased" or "delighted" on LQOLI were found to have significantly lower neurocognitive reasoning performance and poorer insight (ITAQ total score). Our findings underscore the importance of reducing cognitive and insight impairments for both treatment compliance and improved functional outcomes.
authors.affiliation: COS Consulting, Montreal, QC, Canada.
authors.forename: Cynthia O
authors.initials: CO
authors.lastname: Siu
authors.affiliation: University of Miami Miller School of Medicine, Miami, FL, USA; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Harvey
authors.affiliation: Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Ofer
authors.initials: O
authors.lastname: Agid
authors.affiliation: Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Mary
authors.initials: M
authors.lastname: Waye
authors.affiliation: Applied Mathematics and Information Technologies Institute, National Research Council, Milan, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Brambilla
authors.affiliation: Castle Peak Hospital, Tuen Mun, N.T., Hong Kong.
authors.forename: Wing-Kit
authors.initials: WK
authors.lastname: Choi
authors.affiliation: Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Remington
keywords: Insight into illness; neurocognition; patient-rated quality of life; schizophrenia; subjective well-being