Journal of the International Neuropsychological Society

Brief Communications

Is “clinical” insight the same as “cognitive” insight in schizophrenia?

GARY DONOHOEa1 c1, JUDY HAYDENa1, NICOLA McGLADEa2, CARA O’GRÁDAa3, TERESA BURKEa4, SANDRA BARRYa3, CARAGH BEHANa2, TIMOTHY G. DINANa3, EADBHARD O’CALLAGHANa2, MICHAEL GILLa1 and AIDEN P. CORVINa1

a1 Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland

a2 Cluain Mhuire Family Centre and Department of Psychiatry, University College Dublin, Dublin, Ireland

a3 Department of Psychiatry, University College Cork, Cork, Ireland

a4 School of Psychology, University College Dublin, Dublin, Ireland

Abstract

Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state (“clinical insight”) and awareness of cognitive deficits (“cognitive insight”) overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight. (JINS, 2009, 15, 471–475.)

(Received August 20 2008)

(Reviewed January 19 2009)

(Accepted January 19 2009)

Correspondence:

c1 Correspondence and reprint requests to: Gary Donohoe, Department of Psychiatry, Trinity Health Centre, St. James’s Hospital, Dublin 8, Ireland. E-mail: donoghug@tcd.ie