Table 1.

Overview of Common Tools for Assessing Insight

Instrument	Domains	No. of Items
PANSS item G12 (lack of judgment and insight)	Unidimensional, but rating is based on (1) nonrecognition of past or present psychiatric illness or symptoms; (2) denial of need for psychiatric hospitalization or treatment; (3) decisions characterized by poor anticipation of consequences, and unrealistic short-term and long-range planning	1
ITAQ	(1) Recognition of mental illness; (2) need for hospitalization; (3) need to take medications	11
SAI, SAI-E	(1) Awareness and relabeling of symptoms; (2) awareness of illness; (3) treatment compliance	8 (original version), 12 (expanded version)
SUMD	(1) Insight into mental disorder; (2) insight into need for treatment; (3) insight into social consequences; (4) insight into presence of symptoms; (5) insight into attribution of symptoms	74
BIS	(1) Awareness of illness; (2) awareness of need for treatment; (3) relabeling of symptoms	8 (self-report)
BCIS	(1) Self-reflectiveness (expression of introspection and willingness to acknowledge fallibility); (2) self-certainty (certainty about beliefs or judgments)	15 (self-report)

Note: PANSS, Positive and Negative Syndrome Scale; ITAQ, Insight and Treatment Attitudes Questionnaire; SAI-E, Schedule for the Assessment of Insight, Expanded version; SUMD, Scale to Assess Unawareness of Mental Disorder; BIS, Birchwood Insight Scale; BCIS, Beck Cognitive Insight Schedule. All instruments are intended to rate clinical insight, except for the BCIS which is intended to measure cognitive insight. For a more in-depth description, see the review by Lincoln and colleagues.¹⁸