Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-02T18:54:00.035Z Has data issue: false hasContentIssue false

Unawareness of illness and its relationship with depression and self-deception in schizophrenia

Published online by Cambridge University Press:  16 April 2020

O. Moore
Affiliation:
Department of Psychology, University College Belfield Dublin 4
E. Cassidy
Affiliation:
Department of Psychiatry, Cluain Mhuire Service, Hospitaller Order of St. John of God, Newtownpark Avenue Blackrock, Co. Dublin, Ireland
A. Carr
Affiliation:
Department of Psychology, University College Belfield Dublin 4
E. O'Callaghan
Affiliation:
Department of Psychiatry, Cluain Mhuire Service, Hospitaller Order of St. John of God, Newtownpark Avenue Blackrock, Co. Dublin, Ireland
Get access

Summary

Both poor insight and depressive symptomatology are common features of schizophrenia that may be independent of positive and negative symptoms. Forty-six patients with DSM-III-R schizophrenia were evaluated for level of insight (schedule for unawareness of mental disorder), depression (Calgary depression scale for schizophrenia, Beck depression inventory), and self-deception or denial (balanced inventory of desirable responding). Patients with a greater unawareness of their illness had relatively less depressive symptomatology and relatively greater self-deception. This relationship was particularly strong for unawareness of the social consequences of having a mental disorder. These results suggest that the presence of depressive symptomatology in schizophrenia is related to the level of insight, and contingent at least in part on the absence of self-deception as a denial defense.

Type
Original article
Copyright
Copyright © 1999 Éditions scientifiques et médicales Elsevier SAS.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, DAddington, JMaticka-Tyndale, E. Reliability and validity of a depression rating scale for schizophrenics. Schizophr Res 1992; 6: 201208.CrossRefGoogle ScholarPubMed
Addington, DAddington, JAtkinson, MA. A psychometric comparison of the Calgary depression scale for schizophrenia and the Hamilton depression rating scale. Schizophr Res 1996; 19: 205212.CrossRefGoogle ScholarPubMed
Amador, XFStrauss, DHYale, SAGorman, JM. Awareness of illness in schizophrenia. Schizophr Bull 1991; 17: 113132.CrossRefGoogle Scholar
Amador, XFStrauss, DHYale, SAGorman, JMEndicott, J. Assessment of insight in psychosis. Am J Psychiatry 1993; 150: 873879.Google ScholarPubMed
American Psychiatric Association. Diagnostic and statistic manual of mental disorders (revised 3rd edition). Washington DC: American Psychiatric Association; 1987.Google Scholar
Andreasen, NC. Scale for the assessment of negative symptoms (SANS). Iowa City: University of Iowa; 1983.Google Scholar
Andreasen, NC. Scales for the assessment of positive symptoms (SAPS). Iowa City: University of Iowa; 1983.Google Scholar
Beck, ATSteer, RAGarbin, MG. Psychometric properties of the Beck depression inventory: 25 years of evaluation. Clin Psychol Rev 1988; 8: 77100.CrossRefGoogle Scholar
Beisser, AR. Denial and affirmation in illness and health. Am J Psychiatry 1979; 136: 10261030.Google ScholarPubMed
Birchwood, MSmith, JDrury, VHealy, JMacmillan, FSlade, M.A. A self-report insight scale for psychosis: reliability, validity and sensitivity to change. Acta Psychiatr Scand 1994; 89: 6267.CrossRefGoogle ScholarPubMed
Central Statistics Office. Census 86: summary report, second series. Dublin: CSO; 1989.Google Scholar
Dutton, DGHemphill, KJ. Patterns of socially desirable responding among perpetrators and victims of wife assault. Violence Vict 1992; 7: 2939.CrossRefGoogle ScholarPubMed
Kay, SRSevy, S. Pyramidical model of schizophrenia. Schizophr Bull 1990; 16: 537545.CrossRefGoogle ScholarPubMed
Kent, SYellowlees, P. Psychiatric and social reasons for frequent rehospitalization. Hosp Community Psychiatry 1994; 45: 347350.Google ScholarPubMed
Kraepelin, E. Textbook of psychiatry, 8th Edition. New York: Macmillan; 1923.Google Scholar
Markova, ISBerrios, GE. The assessment of insight in clinical psychiatry: a new scale. Acta Psychiatr Scand 1992; 86: 159164.CrossRefGoogle ScholarPubMed
Markova, ISBerrios, GE. Insight in clinical psychiatry. A new model. J Nerv Ment Dis 1995; 183: 743751.CrossRefGoogle ScholarPubMed
McEvoy, JPApperson, LJAppelbaum, PSOrtlip, PBreckosky, JHamill, K. Insight in schizophrenia. Its relationship to acute psychopathology. J Nerv Ment Dis 1989; 177: 4347.CrossRefGoogle ScholarPubMed
McEvoy, JPHartman, MGottlieb, DGodwin, DApperson, LJWilson, W. Common sense, insight and neuropsychological test performance in schizophrenia patients. Schizophr Bull 1996; 22: 635641.CrossRefGoogle ScholarPubMed
McGlashan, THCarpenter, WT. Postpsychotic depression in schizophrenia. Arch Gen Psychiatry 1976; 33: 231239.CrossRefGoogle Scholar
McGlashan, THCarpenter, WT. Does attitude towards psychosis relate to outcome? Am J Psychiatry 1981; 138: 797801.Google Scholar
Michalakeas, ASSkoutas, CCharalambous, APeristeris, AMarinos, VKeramari, E. Insight in schizophrenia and mood disorders and its relation to psychopathology. Acta Psychiatr Scand 1994; 90: 4649.CrossRefGoogle ScholarPubMed
Paulhus, DP. Manual for Balanced Inventory of Desirable Responding (BIDR). Version 6. Toronto/Buffalo: Multi-Health Systems; 1994.Google Scholar
Russell, G. The role of denial in clinical practice. J Adv Nursing 1993; 18: 938940.CrossRefGoogle ScholarPubMed
Sackheim, HASelf-deception, depression and self-esteem: The adaptive value of lying to oneself.In: Masling, JEmpirical studies of psychoanalytic theory. New Jersey: Lawrence Erlbaum; 1983.Google Scholar
Sax, KWStrakowski, SMKeck, PEUpadhyaya, VHWest, SAMcElroy, SL. Relationships among negative, positive and depressive symptoms in schizophrenia and psychotic depression. Br J Psychiatry 1996; 168: 6871.CrossRefGoogle ScholarPubMed
Snaith, P. What do depression rating scales measure? Br J Psychiatry 1993; 163: 293298.CrossRefGoogle ScholarPubMed
Swanson, CLFreudenreich, OMcEvoy, JPNelson, LMamaraju, LWilson, WH. Insight in schizophrenia and mania. J Nerv Ment Dis 1995; 193: 752755.CrossRefGoogle Scholar
World Health Organisation. Report of the international study of schizophrenia. Geneva: WHO Press; 1973.Google Scholar
Submit a response

Comments

No Comments have been published for this article.