The Insight Paradox among Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. METHODS: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. RESULTS: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. CONCLUSION: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

Factors Affecting the Empowerment Experienced by Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: To identify various factors that might affect the empowerment of outpatients with schizophrenia. METHODS: Of patients who had been receiving outpatient treatments at the department of psychiatry in Dong-A university hospital, 116 patients with a DSM-IV-TR diagnosis of stable schizophrenia were enrolled in this study. The empowerment, psychiatric symptoms, social functions, insight, family attitude, social support and self-esteem were assessed through an interview or self-report measures. Overall, multiple regression analyses were performed in consideration of 11 factors (age, sex, level of education, age of onset, frequency of hospitalization, symptoms, social functions, insight, family attitude, social support, self-esteem) as explanatory variables for the empowerment. RESULTS: Multiple regression analyses using a backward elimination revealed that the following four factors were found to be significant explanatory variables for the empowerment: age of onset, social functions, family attitude and self-esteem. A coefficient of determination for these four explanatory variables was 0.65. CONCLUSION: In conclusion, the results showed that four factors, such as age of onset, social functions, family attitude and self-esteem, were found to be significant explanatory variables for the empowerment of outpatients with schizophrenia. Since these four variables accounted for 65% of total empowerment, however, further studies in a larger group of patients are warranted to identify other potential factors for the empowerment.