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The Lack of Insight in Schizophrenia

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The Lack of Insight in Schizophrenia

In my lifetime, I have spent months with my Grandmother, Florence Ernstead, who is a diagnosed paranoid delusional schizophrenic. During this time I have realized that schizophrenics have difficulty realizing the seriousness of their disorders. This inability to acknowledge a problem is known by psychiatrists as lack of insight.

Many psychotic patients, especially schizophrenics, display a lack of insight into their disorder (Keefe 9). Lack of insight refers to an unawareness of having a disorder, unawareness of having psychotic symptoms, and a refusal of treatment. Some scientists include other more specific aspects such as patients' views on cause of their disorder and/or symptoms, hospitalization, control of situation, or perception of the environment. Only the three aspects listed previously, though, seem common to all definitions of what lack of insight encompasses. Lack of insight has been associated with schizophrenia for a while, with all studies on the subject reaching at least this minimal conclusion. However, there have been some differing conclusions on what causes lack of insight in schizophrenia. Two main hypotheses have been presented so far: one is a neuropsychological explanation for lack of insight in schizophrenia while the other is a cognitive explanation. Is lack of insight caused by frontal lobe dysfunction, as in anosognosia and Alzheimer's disease? Or is lack of insight simply a cognitive dysfunction with no connection to brain damage? A third idea is that lack of insight in schizophrenia is related to stigma. Many patients with schizophrenia may deny their disorder because of the stigma related to having schizophrenia. In this paper, I will cover first ...

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