· ISSN 1433-1055 Insight in Schizophrenia – A Comprehensive Update

Objective: To comprehensively review and update the research evidence on insight in schizophrenia. Methods: Search of electronic databases (up to September 2009) as well as manual search of relevant publications or cross references. The search terms used (in various combinations) were: insight, schizophrenia, psychosis, neuropsychol-ogy, neurobiology, instruments, model, prognosis, outcome, psychopathology, therapy. Results: There are several ways of defining and conceptualizing insight. Clinical concept of insight refers to awareness of a mental disorder and its consequences, awareness of need for treatment, awareness of symptoms and attribution of the symptoms to the disorder. Numerous conceptual models have attempted to explain insight: as a symptom, as a defence, as psychological (misattribution) or neuropsychological phenomenon, or from a sociocultural perspective. Neurobiologi-cally, insight has been associated with frontal and other cortical structures implicated in higher mental functions. Sev-eral instruments exist for assessing insight. Clinical correlates of insight are many but always consistent: severity of ill-ness, psychotic symptoms, depressive symptoms, treatment adherence, quality of life, functioning, violence, and compe-tence to consent. Conclusions: In recent years, there has been a surge of research into the conceptualization and assessment of insight, as well as its relationships with prognosis, compliance, neuropsychological impairment and severity of psychopathology i