| Summary: | Poor insight into illness is a prevalent and characteristic feature of schizophrenia. According to the WHO International Pilot study of Schizophrenia, 98% of patients with schizophrenia showed a lack of insight into the presence of their mental disorder. Impaired insight has been linked to poor treatment compliance and thus with poorer outcomes. Despite the negative consequences associated with impaired insight, studies on insight in individuals with schizophrenia have only been conducted in recent years. Even fewer studies have addressed the primary link between poor insight and treatment non-compliance. Through the evaluation of cross-sectional and longitudinal studies, this review proposes that, among other factors, impaired insight is the leading factor in determining treatment non-compliance. Cross-sectional studies have shown strong support for the correlational relationship. Mixed results gathered from longitudinal studies suggest that the role of insight in treatment compliance weakens over time and that long-term compliance is determined by a variety of factors. Despite that, the majority of studies recognise the role of insight in treatment compliance. Hence, insight should be reasonably targeted for intervention as a means to improve treatment compliance and outcomes. Current interventions appear to be effective in improving insight. However, the limitation of these interventions is their lack of consideration of insight as a primary outcome measure. Individual interventions are also unable to address all domains of insight. A multimodal treatment combining the benefits of various interventions appear promising.
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