Functioning, clinical severity, education and sex moderate the inverse relationship between insight and quality of life in patients with schizophrenia.

Doubly-robust estimation Insight Insight paradox Quality of life Rehabilitation Schizophrenia

Journal

Schizophrenia research
ISSN: 1573-2509
Titre abrégé: Schizophr Res
Pays: Netherlands
ID NLM: 8804207

Informations de publication

Date de publication:
22 Dec 2023
Historique:
received: 30 04 2023
revised: 09 11 2023
accepted: 13 12 2023
medline: 24 12 2023
pubmed: 24 12 2023
entrez: 23 12 2023
Statut: aheadofprint

Résumé

In schizophrenia, insight, the recognition that one has a medical illness that requires treatment, has long been related to deteriorated quality of life, a phenomenon that has been described as the "insight paradox". Here, we aimed to determine whether certain socio-demographic and clinical characteristics strengthen or weaken this negative relationship. We used data from the French network of rehabilitation centers REHABase (N = 769). We explored mean differences in quality-of-life scores between patients with good insight vs. poor insight. We also explored modifying effects of socio-demographic and clinical characteristics (sex, education, age, functioning, clinical severity, duration of illness). Patients with good insight had a decreased quality-of-life total score. Similar effects were found for the following sub-dimensions of quality of life: autonomy, physical and psychological well-being, and self-esteem. The negative effect of insight on quality of life was attenuated for people who had >12 years of education and for people with a higher level of functioning. By contrast, the negative effect of insight on quality of life was accentuated in people with greater clinical severity. Functioning and clinical severity showed similar modifying effects for other quality-of-life dimensions: autonomy, physical and psychological well-being, and self-esteem. Finally, males demonstrated an increased negative association between insight and self-esteem. The relationship between insight and quality of life is moderated by socio-demographic and clinical circumstances. Future inquiries may utilize our findings by integrating socio-demographic and clinical factors in treatment programs designs to conjointly improve insight and quality of life.

Sections du résumé

BACKGROUND BACKGROUND
In schizophrenia, insight, the recognition that one has a medical illness that requires treatment, has long been related to deteriorated quality of life, a phenomenon that has been described as the "insight paradox". Here, we aimed to determine whether certain socio-demographic and clinical characteristics strengthen or weaken this negative relationship.
METHODS METHODS
We used data from the French network of rehabilitation centers REHABase (N = 769). We explored mean differences in quality-of-life scores between patients with good insight vs. poor insight. We also explored modifying effects of socio-demographic and clinical characteristics (sex, education, age, functioning, clinical severity, duration of illness).
RESULTS RESULTS
Patients with good insight had a decreased quality-of-life total score. Similar effects were found for the following sub-dimensions of quality of life: autonomy, physical and psychological well-being, and self-esteem. The negative effect of insight on quality of life was attenuated for people who had >12 years of education and for people with a higher level of functioning. By contrast, the negative effect of insight on quality of life was accentuated in people with greater clinical severity. Functioning and clinical severity showed similar modifying effects for other quality-of-life dimensions: autonomy, physical and psychological well-being, and self-esteem. Finally, males demonstrated an increased negative association between insight and self-esteem.
CONCLUSIONS CONCLUSIONS
The relationship between insight and quality of life is moderated by socio-demographic and clinical circumstances. Future inquiries may utilize our findings by integrating socio-demographic and clinical factors in treatment programs designs to conjointly improve insight and quality of life.

Identifiants

pubmed: 38141352
pii: S0920-9964(23)00461-9
doi: 10.1016/j.schres.2023.12.015
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

149-156

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Guillaume Barbalat (G)

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université de Lyon, Lyon, France. Electronic address: Guillaume.Barbalat@ch-le-vinatier.fr.

Lisa Maréchal (L)

Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, CHU et faculté de médecine de Poitiers, Poitiers, France.

Julien Plasse (J)

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université de Lyon, Lyon, France.

Isabelle Chéreau-Boudet (I)

Centre Référent Conjoint de Réhabilitation (CRCR), Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Benjamin Gouache (B)

Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.

Emilie Legros-Lafarge (E)

Centre Référent de Réhabilitation Psychosociale de Limoges (C2RL), Limoges, France.

Catherine Massoubre (C)

REHALise, Centre de Réhabilitation Psychosociale, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France.

Nathalie Guillard-Bouhet (N)

Centre de REhabilitation d'Activités Thérapeutiques Intersectoriel de la Vienne (CREATIV), Centre Hospitalier Laborit, Poitiers, France.

Frédéric Haesebaert (F)

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université de Lyon, Lyon, France.

Nicolas Franck (N)

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université de Lyon, Lyon, France.

Classifications MeSH