Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies
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Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies Wen Li 1 & Hong-He Zhang 2 & Yu Wang 3 & Ling Zhang 4 & Gabor S. Ungvari 5,6 & Teris Cheung 7 & Yu-Tao Xiang 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Poor insight exists in all phases of schizophrenia and is associated with poor clinical prognosis and adverse psychosocial functioning. This is a meta-analysis examining the prevalence of poor insight and its correlates in Chinese patients with schizophrenia. Both major international (PubMed, EMBASE, PsycINFO, and Web of Science) and Chinese (WANFANG and CNKI) databases were systematically searched. The pooled prevalence of poor insight was calculated using the random-effects model. A total of 19 studies with 3112 schizophrenia patients were included. The prevalence of poor insight was 43.4% (95%CI: 36.0%–51.2%). Subgroup and meta-regression analyses revealed that the higher prevalence of poor insight was significantly associated with single-site design, smaller sample size, inpatient status, acute illness phase, higher male proportion, younger age, shorter duration of illness, lower study quality, and earlier publication year. Poor insight is common in Chinese schizophrenia patients. Considering the negative outcomes of poor insight, regular screening and effective psychosocial interventions should be delivered for this vulnerable population. Keywords Schizophrenia . Poor insight . Prevalence . Meta-analysis
Introduction Insight is a multidimensional concept involving patients’ awareness of having a disease, attitude towards treatment need, and awareness of the consequences of the disease [1]. Insight is a “doubleedge sword”. Poor insight is a predominant feature in schizophrenia, manifested in all illness phases [1–3], and is associated with a wide range of negative clinical outcomes, such as poor treatment Wen Li, Hong-He Zhang, Yu Wang and Ling Zhang contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11126-02009786-7) contains supplementary material, which is available to authorized users.
* Yu-Tao Xiang [email protected] Extended author information available on the last page of the article
Psychiatric Quarterly
adherence [4], greater risk of relapse [5] and hospitalization [6], increased aggressive behaviours [7], lower quality of life [8–10], impaired occupational functioning [11], social relationships deficits [12], independent living and self-care deficits [13], and cognitive dysfunctions [14]. Nevertheless, schizophrenia patients with good insight are more likely to experience stigma [6] and comorbid depression [15], which may increase the risk of suicide [16]. As such, insight has long been a central focus in the treatment of schizophrenia. A better understanding of poor insight and its associated factors could benefit the treatment and prognosis of schizophrenia. Evidence suggests that insight is closely associated with sociocultural contexts [17]
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