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JAMA Network Insights
April 29, 2020

Working With Patients With Impaired Insight

Author Affiliations
  • 1Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
JAMA Psychiatry. Published online April 29, 2020. doi:10.1001/jamapsychiatry.2020.0767

Clinical insight broadly refers to a patient’s awareness of illness, ability to attribute symptoms to the illness, recognition of the consequences of symptoms, and appreciation of the need for treatment.1 Most patients with a primary psychotic disorder, such as schizophrenia, demonstrate impaired insight. This impairment can pose substantial challenges for the patient and clinician, and impaired insight is associated with multiple adverse outcomes. Further, insight occurs on a dynamic spectrum and can fluctuate throughout the course of illness.1 This article will address our current understanding of insight in the context of psychotic illness, evaluation of insight, and treatment approaches when working with patients with impaired insight.

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