Monday, March 26, 2012

Schizophrenia research study hogwash

I dunno about you, but I have trouble figuring out what most psychiatric research studies are actually saying. The language is clinical gibberish. Here's a typical example that I found at the Mad in America blog. My own take on this, not what the study actually says, is that depression accompanying  high levels of insight correlate with people correctly interpreting the hopelessness conveyed by their diagnosis. (Note the study's definition of recovery. This is not recovery in my books. What it is is managing your illness.)

The conclusions drawn from this study are some of the reasons I don't believe in mental illness. I do believe that there are people who believe in mental illness, and they will do their best to convince you that you are hopeless. As long as someone else believes you are mentally ill, and you are in close proximity to that person, chances are you will remain mentally ill.

The Role of Subjective Illness Beliefs and Attitude Toward Recovery Within the Relationship of Insight and Depressive Symptoms Among People With Schizophrenia Spectrum Disorders

  • psychosis;
  • awareness;
  • demoralization;
  • illness perception;
  • recovery;
  • hope


Low levels of insight are a risk factor for treatment nonadherence in schizophrenia, which can contribute to poor clinical outcome. On the other hand, high levels of insight have been associated with negative outcome, such as depression, hopelessness, and lowered quality of life. The present study investigates mechanisms underlying the association of insight and depressive symptoms and protective factors as potential therapeutic targets.


One hundred and forty-two outpatients with schizophrenia or schizoaffective disorder (35.2% women, mean age of 44.83 years) were studied using questionnaires and interviews to assess insight, depressive symptoms, recovery attitude, and illness appraisals with regard to course, functional impairments, and controllability. Psychotic and negative symptoms were assessed as control variables. The cross-sectional data were analyzed using structural equation models and multiple linear regression analyses with latent variables.


Higher levels of insight and psychotic symptoms were associated with more depressive symptoms. The association of negative symptoms with depressive symptoms was not significant. The relationship between insight and depressive symptoms was mediated by the participants’ perception of their illness as being chronic and disabling, as well as suppressed by their expectation of symptom control due to treatment. Finally, the association of insight and depressive symptoms was less pronounced in the patients with a positive recovery attitude than in those without this protective factor.


To achieve recovery, which includes symptom reduction, functional improvement, and subjective well-being, it is necessary to prevent depressive symptoms as indicators of a demoralization process, which may arise as a consequence of growing insight. Possible treatment strategies focusing on changes of dysfunctional beliefs about the illness and the self and inducing a positive recovery attitude are discussed.


  1. "Higher levels of insight associated with depression"---go figure! What person wouldn't be after being told they have a freaking brain disease which will never go away! Implicit in this life sentence is "What you think is the problem, (if there even is one) your thoughts, your feelings and your life experiences are basically irrelevant. Your so-called disease is driving everything...Who the fuck wouldn't be depressed?! It is invalidation that is absolute for fuck's sake! To think this judgement is without anything more definitive than a freaking BELIEF to support it is simply astounding.

    One of the things I find incredible is the same 'suffering parents and family' of these targeted people have no fucking problem describing how they are affected by 'the schizophrenic' and develop 'issues' of their own requiring psych drugs to sleep, for anxiety, yada yada---and do not think their own behavior has an impact on 'the schizophrenic.'

    It is ironic to say the least, that it is the people with a diagnosis of schizophrenia who are said to 'lack insight.'

  2. When Chris got major depression after being in the hospital for a few weeks after his diagnosis (his depression showed greatinsight according to this study), the treatment that was considered for him was electroshock. Is ECT what the study means by:

    "Possible treatment strategies focusing on changes of dysfunctional beliefs about the illness and the self and inducing a positive recovery attitude are discussed."

    Of course, what I printed in the post is just the abstract for the article. It may very well be that the study discusses humane treatment options. I hope so, but it's really hard to tell because of all the clinical gibberish, what exactly the authors are advocating.

  3. it seems to me that psychiatric symptoms are rarely considered in contest of the intra- and interpersonal subjective experiences/conflicts a person has. It's all about the biological organism...Unless bio-psychiatry can drop the assumption of disease or defect, and truly respectfully connect with people; not simply assess, judge and classify behaviors as signs of disease/defect; it's 'patients' will be victims.

  4. These researchers sound like a bunch of babbling buffoons.

    What can I say?


  5. What they are saying is pretty obvious if you understand the language, and it is no more complex than anything you would find in a scholarly journal on physics or chemisty. High levels of awareness of the disease are linked to hopelessness which could be solved with therapy, however low levels of insight into the illness breed noncompliance with therapy (Ie the afflicted might say "I'm not sick, you all are crazy and are trying to control me")

    The point of this study is to underline the need for some kind of support to help those who are paranoid about getting help or think there situation is useless, which it is not.

  6. Rossa,

    An inquiry is being done by UK and 23 international groups to address the harm caused by the label of "schizophrenia" -

    IMO, if there is one area that needs more research, it's in the label itself!



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