Insight In Psychosis: A Conceptual Analysis [insight Na Psicose: Uma Análise Conceitual]

Introduction: In the context of clinical psychiatry, insight is defined as a subcategory of self-awareness of patients, which is related to the recognition of the pathological manifestations that affect them and also the appreciation of the changes that these manifestations cause in their interaction with the outside world. Objective: To examine the forms of presentation of insight in schizophrenia and other psychoses. Methods: Conceptual analysis, with illustrative clinical vignettes, of the relation between insight and several symptomatologic dimensions of schizophrenia and related conditions, regarding clinical, neurocognitive, psychodynamic and transcultural aspects. Results: From a conceptual point of view, the construct is shaped by the theoretical approach adopted; from a clinical point of view, its presentation in psychoses is the result of the interaction with different symptomatologic areas and subjective and cultural aspects of the patient. Conclusion: Psychopathology assessment of insight must consider the complexity of the phenomenon, the theoretical approach used, and the clinical purpose for which it is done.602135140Dantas, C.R., Banzato, C.E.M., (2006) Adaptação Transcultural Do "Schedule for the Assessment of Insight - Expanded Version (SAI-E)", Estudo De Confiabilidade E Análise Fatorial Da Versão Brasileira Do SAI-E [dissertação], , Campinas (SP): Universidade Estadual de CampinasFulford, K.W.M., Completing Kraepelin's psychopathology: Insight, delusion, and the phenomenology of illness (1998) Insight and Psychosis, , In: Amador XF, David AS, New York: Oxford University PressLewis, A., The psychopathology of insight (1934) Br J Med Psychol, 14, pp. 332-348Marková, I.S., Berrios, G.E., The meaning of insight in clinical psychiatry (1992) Br J Psychiatry, 161, pp. 850-860Marková, I.S., Berrios, G.E., Insight in clinical psychiatry. A new model (1995) J Nerv Ment Dis, 183, pp. 743-751Marková, I.S., Berrios, G.E., Insight in clinical psychiatry revisited (1995) Compr Psychiatry, 36, pp. 367-376(1973) Report of the International Pilot Study of Schizophrenia, , World Health Organization, Geneva: WHOAmador, X.F., Andreasen, N.C., Flaum, M., Strauss, D.H., Yale, S.A., Clark, S., Awareness of illness in schizophrenia, schizoaffective and mood disorders (1994) Arch Gen Psychiatry, 51, pp. 826-836Kim, C., Jayathilake, K., Meltzer, H.Y., Hopelessness, neurocognitive function, and insight in schizophrenia: Relationship to suicidal behavior (2003) Schizophr Res, 60, pp. 71-80Schwartz, R.C., Smith, S.D., Suicidality and psychosis: The predictive potential of symptomatology and insight into illness (2004) J Psychiatr Res, 38, pp. 185-191Dantas, C.R., Barros, B.R., Fernandes, P.T., Li, L.M., Banzato, C.E.M., Insight controlled for cognition in deficit and nondeficit schizophrenia (2011) Schizophr Res, 128 (1-3), pp. 124-126. , Epub 2011 Feb 24Amador, X.F., Kronengold, H., (1998) The Description and Meaning of Insight in Psychosis, , Amador XF, David AS. Insight and psychosis. New York: Oxford University PressSackeim, H.A., Introduction: The meaning of insight (1998) Insight and Psychosis, , In: Amador XF, David AS, New York: Oxford University PressBeck, A.T., Baruch, E., Balter, J.M., Steer, R.A., Warman, D.M., A new instrument for measuring insight: The Beck Cognitive Insight Scale (2004) Schizophr Res, 68, pp. 319-329Shad, M.U., Muddasani, S., Prasad, K., Sweeney, J.A., Keshavanan, M.S., Insight and prefrontal cortex in first-episode schizophrenia (2004) Neuroimage, 22, pp. 1315-1320Kemp, R., David, A., Insight and compliance (1997) Compliance and The Treatment Alliance in Serious Mental Illness, , In: Blackwell B, editor, Amsterdam: Hardwood Academy PublishersTranulis, C., Corin, E., Kirmayer, L.J., Insight and psychosis: Comparing the perspectives of patient, entourage and clinician (2008) Int J Soc Psychiatry, 54, pp. 225-241Saravanan, B., Jacob, K.S., Prince, M., Bhugra, D., David, A.S., Culture and insight revisited (2004) Brit J Psychiatry, 184 (2), pp. 107-109Dantas, C.R., Banzato, C.E.M., Predictors of insight in psychotic patients (2007) Schizophr Res, 91, pp. 263-26