Brief Communication Insight and Neuropsychological Function in Patients With Schizophrenia and Bipolar Disorder With Psychotic Features

The etiopathogenetic mechanisms of lack of insight in pa-tients with schizophrenia are to date unknown, although several hypotheses have been suggested. At first, lack of in-sight was understood as a denial of illness (for example, as an abnormal coping mechanism or an abnormal psychological defense) (1). A neuropsychological approach has also been described, and finally, an alternative clinical hypothesis has been proposed, based on the independence of lack of insight from positive and negative schizophrenia symptoms. This hypothesis considers that lack of insight arises directly from the illness process and can be considered as a “primary ” and “basic ” symptom, in Bleulerian terminology (2). The idea of a complex relation between insight and neuropsychological function induced some investigators, us-ing the Wisconsin Card Sort Test (WCST), to explore insight impairment in subjects with schizophrenia, with positive find