Key clinical point: About half of institutionalized adults with schizophrenia score above the average total score on the Scale to Assess Unawareness of Mental Disorder (SUMD).

Major finding: The average total insight score among the patients was 13.7 on a scale of 3 to 27; 49% scored above the average.

Study details: The data come from an institutional-based cross-sectional study of 455 adult schizophrenia patients.

Disclosures: The study was supported by a joint program from University of Gondar and Amanuel Mental Specialized Hospital. The researchers disclosed no financial conflicts.

Commentary

Insight—the ability of individuals to be aware their illness, appreciate the effect of symptoms on functioning, and understand potential factors that can both improve or worsen outcomes—is known to be impaired in a variety psychiatric conditions including schizophrenia. This cross-sectional assessment of adults with schizophrenia conducted in Ethiopia found that poor insight was associated with more severe positive and negative symptoms and that higher levels of insight were associated with more depressive symptoms. Findings generally align with results conducted in samples from other countries. Given the importance of insight in prognosis and health outcomes, including treatment adherence and engagement, assessment of insight is important in developing treatment plans that may optimize recovery.—Martha Sajatovic, MD, Professor of Psychiatry and of Neurology; Willard Brown Chair in Neurological Outcomes Research; Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center; Case Western Reserve University School of Medicine.