Insight in psychosis: Influence of cognitive ability and self-esteem

Abstract

Background: Insight in psychosis has previously been associated with both depression and cognitive ability. Some studies have found a curvilinear relationship between insight and cognitive ability, but the roles of self-esteem and depression have not been taken into account. Aims: To investigate the relationships between insight and IQ, depression, and self-esteem. Method: Correlations between self-reported and observer-rated insight, and measures of IQ, depression and self-esteem were examined in 67 people with psychosis. Results: Better self-reported insight was associated with higher IQ and poorer self-esteem, but not depression. There was some evidence for a curvilinear relationship between IQ and self-reported insight, specifically the 'awareness of illness' dimension, which survived correction for symptom variables. Conclusions: The relationship between insight and IQ might reflect both the basis of insight in intellectual ability and the influence of a psychological mechanism that preserves self-esteem. Declaration of interest: None. Funding detailed in Acknowledgements.