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Relationship between cognitive insight and subjective quality of life in outpatients with schizophrenia

Authors Kim J, Lee S, Han A, Kim K, Lee J

Received 8 June 2015

Accepted for publication 8 July 2015

Published 7 August 2015 Volume 2015:11 Pages 2041—2048

DOI https://doi.org/10.2147/NDT.S90143

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 3

Editor who approved publication: Professor Wai Kwong Tang

Jong-Hoon Kim,1 Seul Lee,1 Ah-Young Han,1 Kyungwook Kim,2 Jinyoung Lee1

1Neuroscience Research Institute, Department of Psychiatry, Gil Medical Center, Gachon University School of Medicine, Gachon University, Incheon, Republic of Korea; 2Department of Medicine, Gachon University School of Medicine, Gachon University, Incheon, Republic of Korea

Background: The concept of cognitive insight refers to the cognitive processes involved in patients’ re-evaluation of their anomalous experiences and of their misinterpretations. The purpose of the present study was to examine the relationship between cognitive insight and subjective quality of life in patients with schizophrenia to further shed light on the nature of cognitive insight and its functional correlates in schizophrenia.
Methods: Seventy-one stable outpatients with schizophrenia were evaluated for cognitive insight and subjective quality of life using the Beck Cognitive Insight Scale (BCIS) and the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4). The symptoms of schizophrenia were also assessed. Pearson’s correlation analysis and partial correlation analysis that controlled for the severity of symptoms were performed to adjust for the possible effects of symptoms.
Results: The self-reflectiveness subscale score of the BCIS had significant positive correlations with the SQLS-R4 psychosocial domain and total SQLS-R4 scores, indicating that the higher the level of cognitive insight, the lower the subjective quality of life. In partial correlation analysis controlling for symptoms, the BCIS self-reflectiveness subscale score still had a significant correlation with the SQLS-R4 psychosocial domain score. The correlation coefficient between the BCIS self-reflectiveness and total SQLS-R4 scores was reduced to a nonsignificant statistical tendency.
Conclusion: The results of our study suggest that cognitive insight, particularly the level of self-reflectiveness, is negatively associated with the level of subjective quality of life in outpatients with schizophrenia and that this relationship is not wholly due to the confounding effect of symptoms. Future studies are necessary to explore possible mediating and moderating factors and to evaluate the effects of therapeutic interventions on the relationship.

Keywords: cognitive insight, self-reflectiveness, subjective quality of life, depressive symptoms, schizophrenia

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