Abstract:
:Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patients have no or only partial insight and consequently do not comply with treatment is rooted in the nature of their anomalous self-experiences (ie, self- disorders) and the related articulation of their psychotic symptoms. We argue that self-disorders destabilize the patients' experiential framework, thereby weakening their basic sense of reality (natural attitude) and enabling another sense of reality (solipsistic attitude) to emerge and coexist. This coexistence of attitudes, which Bleuler termed "double bookkeeping," is, in our view, central to understanding what poor insight in schizophrenia really is. We suggest that our phenomenologically informed account of poor insight may have important implications for early intervention, psychoeducation, and psychotherapy for schizophrenia.
journal_name
Schizophr Bulljournal_title
Schizophrenia bulletinauthors
Henriksen MG,Parnas Jdoi
10.1093/schbul/sbt087subject
Has Abstractpub_date
2014-05-01 00:00:00pages
542-7issue
3eissn
0586-7614issn
1745-1701pii
sbt087journal_volume
40pub_type
杂志文章abstract::Migration is a major risk factor for schizophrenia but the neurochemical processes involved are unknown. One candidate mechanism is through elevations in striatal dopamine synthesis and release. The objective of this research was to determine whether striatal dopamine function is elevated in immigrants compared to non...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw181
更新日期:2017-03-01 00:00:00
abstract::Patients describe experiencing personal recovery despite ongoing symptoms of psychosis. The aim of the current research was to perform a meta-analysis investigating the relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders. A comprehensive OvidSP database search was perf...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbx088
更新日期:2018-04-06 00:00:00
abstract::Childhood trauma (CT) has been identified as a potential risk factor for the onset of psychotic disorders. However, to date, there is limited consensus with respect to which symptoms may ensue after exposure to trauma in early life, and whether specific pathways may account for these associations. The aim of the prese...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw055
更新日期:2017-01-01 00:00:00
abstract::This meta-analytic review sought to answer questions concerning the role of psychosocial treatments in the comprehensive management of patients with schizophrenia. The review focused on the effects of combining psychosocial treatment with somatic treatment. Findings demonstrated the additive and supplementary effects ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析
doi:10.1093/oxfordjournals.schbul.a033350
更新日期:1998-01-01 00:00:00
abstract::Schizophrenia patients have higher scores on neurological soft-signs (NSS) and show greater deficits on a variety of neuropsychological tests than normal control subjects and mixed groups of psychiatric patients. Among chronic schizophrenia patients it is unclear which of these types of deficits most strongly differen...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033421
更新日期:1999-01-01 00:00:00
abstract::To better characterize hippocampal pathophysiology in schizophrenia, we conducted a longitudinal study evaluating hippocampal functional connectivity during resting state, using seeds prescribed in its anterior and posterior regions. We enrolled 34 unmedicated patients with schizophrenia or schizoaffective disorder (S...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbv228
更新日期:2016-07-01 00:00:00
abstract::Traditional psychiatric treatment approaches have not been very successful with the "revolving door patient." A variety of findings suggest that the social network, as opposed to the individual patient, may be a more viable locus for intervention. A conceptual review and analysis of the literature reveals two construc...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/12.2.262
更新日期:1986-01-01 00:00:00
abstract::Abnormal reinforcement learning and representations of reward value are present in schizophrenia, and these impairments can manifest as deficits in risk/reward decision making. These abnormalities may be due in part to dopaminergic dysfunction within cortico-limbic-striatal circuitry. Evidence from studies with labora...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbu165
更新日期:2015-01-01 00:00:00
abstract::Persistent negative symptoms represent an alternative approach for assessing negative symptoms in the context of clinical trials. Persistent negative symptoms are designed to capture those symptoms that lead to functional impairment but are currently understudied and for which there are no currently available effectiv...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbl057
更新日期:2007-07-01 00:00:00
abstract::The purpose of this study was (1) to identify the demographic and psychosocial characteristics of Korean-Americans with schizophrenia, and (2) to compare the demographic and psychosocial characteristics of Korean-Americans with schizophrenia to African-American, Latino, and Euro-American individuals with schizophrenia...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a006974
更新日期:2002-01-01 00:00:00
abstract::Data provided by case managers in community support programs are used to analyze the problems of families providing shelter to mentally ill relatives. Factors affecting complaints in 345 family households are contrasted with factors leading to complaints in a subsample of 622 other residential alternatives. Behavioral...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/13.4.727
更新日期:1987-01-01 00:00:00
abstract::Changed synapse density has been suggested to be involved in the altered brain connectivity underlying schizophrenia (SCZ) pathology. However, postmortem studies addressing this topic are heterogeneous and it is not known whether changes are restricted to specific brain regions. Using meta-analysis, we systematically ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbz060
更新日期:2020-02-26 00:00:00
abstract::Catechol-O-methyl transferase (COMT) is a catabolic enzyme involved in the degradation of a number of bioactive molecules; of principal interest to psychiatry, these include dopamine. The enzyme is encoded by the COMT gene. COMT is located (along with 47 other genes) in a fragment of chromosome 22q11 which when delete...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbm019
更新日期:2007-05-01 00:00:00
abstract:UNLABELLED:We aimed to discover whether metabolic complications of schizophrenia (SZ) are present in first episode (FE) and unmedicated (UM) patients, in comparison with patients established on antipsychotic medication (AP). METHOD:A systematic search, critical appraisal, and meta-analysis were conducted of studies to...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbs082
更新日期:2013-03-01 00:00:00
abstract::Similarities in clinical course, age of onset, geographical distribution, and immunological responses of patients with schizophrenia and multiple sclerosis (MS) suggest that these two common illnesses of young adults may belong to a similar class of disorders. This review examines some of the similarities and differen...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/14.2.231
更新日期:1988-01-01 00:00:00
abstract::This article focuses on the schizophrenic disorganization syndrome, which was initially described by Bleuler (who used the term "dissociation") as lying at the heart of schizophrenia. While adopting a neo-Bleulerian approach, we describe schizophrenic disorganization using a pathogenetic hypothesis and a three-part st...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a007019
更新日期:2003-01-01 00:00:00
abstract::Antipsychotics, cognitive behavioral therapy (CBT), and omega-3-fatty acids have been found superior to control conditions as regards prevention of psychosis in people at-risk of first-episode psychosis. However, no large-scale trial evaluating the differential efficacy of CBT and antipsychotics has been performed yet...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/schbul/sbr083
更新日期:2011-09-01 00:00:00
abstract::We found diurnal weight gain to be abnormal among 93 chronically psychotic patients, most of whom had schizophrenia. They were weighed at 7 a.m. and 4 p.m. weekly for 3 weeks. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 a.m. weight from the 4 p.m. weight, multiplying the differenc...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/15.3.501
更新日期:1989-01-01 00:00:00
abstract::This study investigated the role of reasoning biases in delusion formation and maintenance. Reasoning judgments have been shown to be influenced by prior knowledge, beliefs, and experience--that is, information stored in semantic memory. It was hypothesized that high schizotypes would exhibit a "jump to conclusions" s...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbi012
更新日期:2005-01-01 00:00:00
abstract::In subjects at risk for psychosis, the studies on gray matter volume (GMV) predominantly reported volume loss compared with healthy controls (CON). However, other important morphological measurements such as cortical surface area (CSA) and cortical thickness (CT) were not systematically compared. So far, samples mostl...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbaa066
更新日期:2020-12-01 00:00:00
abstract::On September 18, 2007, a collaborative session between the International Society for CNS Clinical Trials and Methodology and the International Society for CNS Drug Development was held in Brussels, Belgium. Both groups, with membership from industry, academia, and governmental and nongovernmental agencies, have been f...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbn110
更新日期:2010-05-01 00:00:00
abstract::The search for a treatment of tardive dyskinesia (TD) has focused largely on cholinergic and GABAergic agents that are believed to attenuate striatal imbalances and bring about symptomatic control of dyskinetic movements. While numerous reports of the partial effectiveness of acute treatment with cholinergic or GABAer...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/7.4.571
更新日期:1981-01-01 00:00:00
abstract::The multilevel control of eye movements for the researcher in the schizophrenic disease process includes the saccadic trajectory, the dual mode tracking system, and schematically directed eye movements in fixation, in scanpaths, and other looking strategies, and in reading. Coordination of eye movements with head move...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/9.1.55
更新日期:1983-01-01 00:00:00
abstract::We have previously reported on typically paranoid schizophrenic patients who attempted to see the President or other prominent American political figures based on hallucinations or delusional beliefs. By obtaining arrest records on these White House Cases (WHCs), we were able to determine which individuals had murder ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/14.2.279
更新日期:1988-01-01 00:00:00
abstract::The goals of the project Social Cognition and Functioning in Schizophrenia (SCAF) were to (1) identify the domains to target from social neuroscience for translation to clinical schizophrenia research, (2) identify the paradigms that represent these domains for which the neural substrates are well documented, (3) adap...
journal_title:Schizophrenia bulletin
pub_type:
doi:10.1093/schbul/sbt128
更新日期:2013-11-01 00:00:00
abstract::We report a 25-year followup of a group of 50 children at genetic risk for schizophrenia (by virtue of having a parent with the disorder) and 50 matched controls. The children who eventually developed schizophrenia spectrum disorders, including schizophrenia, were identifiable by cognitive-psychophysiological, neuroin...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/21.2.227
更新日期:1995-01-01 00:00:00
abstract::The authors describe an easily administered scale being developed to assess the rejecting feelings of family respondents toward former mental patients who return to live with their families. Based upon a sample of 133 discharged mental patients and family members, the scale demonstrates a moderately high reliability (...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/5.2.220
更新日期:1979-01-01 00:00:00
abstract::The apparent neglect of neuropsychologic deficits in schizophrenia as the basis for therapeutic intervention, together with only isolated attempts at remediating them, probably reflect the nature of impairments, the functional significance of which is uncertain. A critique of the limitations inherent in the appealing ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/18.1.51
更新日期:1992-01-01 00:00:00
abstract::In response to my discussion of sex differences in concordance rates for schizophrenia in twins, Lewine (1979) noted that male schizophrenics are hospitalized earlier than females. He questioned whether females had been followed through the risk period. To clarify, I calculated the age at followup of discordant twins ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/5.1.8
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Task-based functional neuroimaging studies of schizophrenia have not yet replicated the increased coordinated hyperactivity in speech-related brain regions that is reported with symptom-capture and resting-state studies of hallucinations. This may be due to suboptimal selection of cognitive tasks. METHODS:I...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbu004
更新日期:2015-01-01 00:00:00