Skip to main content
NCBI home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1990 May;83(5):325–329. doi: 10.1177/014107689008300517

On insight and psychosis: discussion paper.

A S David 1
PMCID: PMC1292655  PMID: 2199672

Abstract

The concept of insight into psychosis has received scant attention in the psychiatric literature. Various types of insight are described after drawing on such sources as phenomenology, clinical observation and experimental psychology. It is proposed that insight is far from an all or none phenomenon but comprises three overlapping dimensions, namely, the recognition that one has a mental illness, compliance with treatment and the ability to re-label unusual mental events (delusions and hallucinations) as pathological.

Full text

PDF
325

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bauer R. M. Autonomic recognition of names and faces in prosopagnosia: a neuropsychological application of the Guilty Knowledge Test. Neuropsychologia. 1984;22(4):457–469. doi: 10.1016/0028-3932(84)90040-x. [DOI] [PubMed] [Google Scholar]
  2. Brooks G. W., Deane W. N., Hugel R. W. Some aspects of the subjective experience of schizophrenia. Dis Nerv Syst. 1968 May;29(5 Suppl):78–82. [PubMed] [Google Scholar]
  3. Brown R. Schizophrenia, language, and reality. Am Psychol. 1973 May;28(5):395–403. doi: 10.1037/h0034694. [DOI] [PubMed] [Google Scholar]
  4. Cutting J., Murphy D. Schizophrenic thought disorder. A psychological and organic interpretation. Br J Psychiatry. 1988 Mar;152:310–319. doi: 10.1192/bjp.152.3.310. [DOI] [PubMed] [Google Scholar]
  5. Garety P. A., Hemsley D. R. Characteristics of delusional experience. Eur Arch Psychiatry Neurol Sci. 1987;236(5):294–298. doi: 10.1007/BF00380955. [DOI] [PubMed] [Google Scholar]
  6. Garety P. Delusions: problems in definition and measurement. Br J Med Psychol. 1985 Mar;58(Pt 1):25–34. doi: 10.1111/j.2044-8341.1985.tb02611.x. [DOI] [PubMed] [Google Scholar]
  7. Greer S. Cancer and the mind. Maudsley Bequest Lecture delivered before the Royal College of Psychiatrists, February 1983. Br J Psychiatry. 1983 Dec;143:535–543. doi: 10.1192/bjp.143.6.535. [DOI] [PubMed] [Google Scholar]
  8. Heinrichs D. W., Cohen B. P., Carpenter W. T., Jr Early insight and the management of schizophrenic decompensation. J Nerv Ment Dis. 1985 Mar;173(3):133–138. doi: 10.1097/00005053-198503000-00001. [DOI] [PubMed] [Google Scholar]
  9. Hemsley D. R., Garety P. A. The formation of maintenance of delusions: a Bayesian analysis. Br J Psychiatry. 1986 Jul;149:51–56. doi: 10.1192/bjp.149.1.51. [DOI] [PubMed] [Google Scholar]
  10. Huq S. F., Garety P. A., Hemsley D. R. Probabilistic judgements in deluded and non-deluded subjects. Q J Exp Psychol A. 1988 Nov;40(4):801–812. doi: 10.1080/14640748808402300. [DOI] [PubMed] [Google Scholar]
  11. Kendler K. S., Glazer W. M., Morgenstern H. Dimensions of delusional experience. Am J Psychiatry. 1983 Apr;140(4):466–469. doi: 10.1176/ajp.140.4.466. [DOI] [PubMed] [Google Scholar]
  12. Lin I. F., Spiga R., Fortsch W. Insight and adherence to medication in chronic schizophrenics. J Clin Psychiatry. 1979 Oct;40(10):430–432. [PubMed] [Google Scholar]
  13. Marks I., Mishan J. Dysmorphophobic avoidance with disturbed bodily perception. A pilot study of exposure therapy. Br J Psychiatry. 1988 May;152:674–678. doi: 10.1192/bjp.152.5.674. [DOI] [PubMed] [Google Scholar]
  14. McEvoy J. P., Aland J., Jr, Wilson W. H., Guy W., Hawkins L. Measuring chronic schizophrenic patients attitudes toward their illness and treatment. Hosp Community Psychiatry. 1981 Dec;32(12):856–858. doi: 10.1176/ps.32.12.856. [DOI] [PubMed] [Google Scholar]
  15. McGlashan T. H., Carpenter W. T., Jr Does attitude toward psychosis relate to outcome? Am J Psychiatry. 1981 Jun;138(6):797–801. doi: 10.1176/ajp.138.6.797. [DOI] [PubMed] [Google Scholar]
  16. McGlynn S. M., Schacter D. L. Unawareness of deficits in neuropsychological syndromes. J Clin Exp Neuropsychol. 1989 Mar;11(2):143–205. doi: 10.1080/01688638908400882. [DOI] [PubMed] [Google Scholar]
  17. Milton F., Patwa V. K., Hafner R. J. Confrontation vs. belief modification in persistently deluded patients. Br J Med Psychol. 1978 Jun;51(2):127–130. doi: 10.1111/j.2044-8341.1978.tb02456.x. [DOI] [PubMed] [Google Scholar]
  18. Pilowsky I. A general classification of abnormal illness behaviours. Br J Med Psychol. 1978 Jun;51(2):131–137. doi: 10.1111/j.2044-8341.1978.tb02457.x. [DOI] [PubMed] [Google Scholar]
  19. REID J. R., FINESINGER J. E. The role of insight in psychotherapy. Am J Psychiatry. 1952 Apr;108(10):726–734. doi: 10.1176/ajp.108.10.726. [DOI] [PubMed] [Google Scholar]
  20. Roback H. B., Abramowitz S. I. Insight and hospital adjustment. Can J Psychiatry. 1979 Apr;24(3):233–236. doi: 10.1177/070674377902400307. [DOI] [PubMed] [Google Scholar]
  21. Sacks M. H., Carpenter W. T., Jr, Strauss J. S. Recovery from delusions. Three phases documented by patient's interpretation of research procedures. Arch Gen Psychiatry. 1974 Jan;30(1):117–120. doi: 10.1001/archpsyc.1974.01760070093015. [DOI] [PubMed] [Google Scholar]
  22. Soskis D. A., Bowers M. B. The schizophrenic experience. A follow-up study of attitude and posthospital adjustment. J Nerv Ment Dis. 1969 Dec;149(6):443–449. [PubMed] [Google Scholar]
  23. Sperry R. W. Hemisphere deconnection and unity in conscious awareness. Am Psychol. 1968 Oct;23(10):723–733. doi: 10.1037/h0026839. [DOI] [PubMed] [Google Scholar]
  24. Strauss J. S. Hallucinations and delusions as points on continua function. Rating scale evidence. Arch Gen Psychiatry. 1969 Nov;21(5):581–586. doi: 10.1001/archpsyc.1969.01740230069010. [DOI] [PubMed] [Google Scholar]
  25. Taylor F. K. On pseudo-hallucinations. Psychol Med. 1981 May;11(2):265–271. doi: 10.1017/s0033291700052089. [DOI] [PubMed] [Google Scholar]
  26. Taylor P. J. Motives for offending among violent and psychotic men. Br J Psychiatry. 1985 Nov;147:491–498. doi: 10.1192/bjp.147.5.491. [DOI] [PubMed] [Google Scholar]
  27. Van Putten T., Crumpton E., Yale C. Drug refusal in schizophrenia and the wish to be crazy. Arch Gen Psychiatry. 1976 Dec;33(12):1443–1446. doi: 10.1001/archpsyc.1976.01770120047004. [DOI] [PubMed] [Google Scholar]
  28. WING J. K., MONCK E., BROWN G. W., CARSTAIRS G. M. MORBIDITY IN THE COMMUNITY OF SCHIZOPHRENIC PATIENTS DISCHARGED FROM LONDON MENTAL HOSPITALS IN 1959. Br J Psychiatry. 1964 Jan;110:10–21. doi: 10.1192/bjp.110.464.10. [DOI] [PubMed] [Google Scholar]
  29. ZILBOORG G. The emotional problem and the therapeutic role of insight. Psychoanal Q. 1952;21(1):1–24. [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES