Lack of Insight and Concomitant Neuro- psychological Deficits in Schizophrenia

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Abstract
Lack of insight is a core pathological feature of schizophrenia. It has been assumed to be part of the dysregulation of executive dysfunction evident in this disorder. Lack of insight has also been found to be associated with amnestic disorders. As schizophrenia is additionally characterized by memory deficits, we investigated which of the two cognitive impairments - executive dysfunction or memory deficits - accounted better for lack of insight in this disorder. Eighty-one chronic schizophrenic patients and 38 healthy control probands took part in the study. The patients were recruited in Canada, the UK, Germany and Croatia. Patients were assessed with regard to clinical symptoms and the awareness of mental illness; both groups were administered neuropsychological tests of verbal memory, verbal learning, and executive function. Schizophrenic patients performed less well than healthy controls in all areas of cognitive function. Multiple regression analyses revealed that lack of awareness of schizophrenic disorder is best accounted for by poor verbal memory and disorganization.