Table 4.

Longitudinal Studies Investigating the Impact of Insight on Social Adjustment and Functional Outcome

Study	Design	Participants	Measures	Results
Soskis and Bowers24	Baseline at discharge, follow-up range 3–7 y	32 patients with schizophrenia	Insight: Attitude questionnaire	Social adjustment—a positive, integrating attitude was correlated with higher levels of performance of socially expected activities and lower levels of symptom discomfort
			Outcome: Brief Follow-up Rating, Katz Adjustment Scale
Lysaker89	At baseline enrolled in rehabilitation, 5-wk follow-up	42 patients with schizophrenia and schizoaffective disorder (DSM-III-R)	Insight: PANSS	Work performance and participation—insight was significantly related to fewer weeks of participation (r = −.37), poorer social skills (r = −.37), and personal presentation on the job (r = −.33). In a stepwise regression analyses controlling for symptoms, insight was not significant.
			Outcome: Work Personality Profile, Work participation
Schwartz et al79	Inpatient at baseline, 1-y follow-up	23 patients with chronic schizophrenia (DSM-IV)	Insight: SUMD	Functional level—significant relationship between total insight and Functional Skill Rating Form baseline (r = .53) and follow-up scores (r = .70) and Global Assessment of Functioning follow-up scores (r = .65). Insight into illness accounted for 28% of the variance in functional skill level at baseline and approximately half of the variance in functional skill and global functioning after treatment. Insight did not predict functional skills and global functioning at initial assessment but improvement by follow-up.
			Outcome: Global Assessment of Functioning, Functional Skill Rating Form
Lysaker et al7	Outpatient at baseline, 3-, 5-, and 7-wk follow-up	85 patients with schizophrenia and schizoaffective disorder (SCID)	Insight: SUMD	Work performance—after controlling for neurocognitive deficits, the impaired insight group showed significantly poorer performance in cooperativeness and personal presentation, trends in poorer work habits and quality, and no differences for social skills.
			Outcome: Work Behavior Inventory
Yen et al 76	Outpatient at baseline, 1-y follow-up	74 patients with schizophrenia (DSM-IV)	Insight: SAI, SAI-E	Social functioning-patients with good social adjustment had higher index scores for insight into treatment than patients with poor social adjustment. There were no differences for the other SAI and SAI-E scores
			Outcome: Community Life Scale

Note: Abbreviations are explained in footnote to table 1. DSM-III-R, Diagnostic and Statistical Manual for Mental Disorders, Revised Third Edition; DSM-IV, Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition.