P-1215 - Possible consequences of insight in schizophrenia

Introduction Insight in schizophrenia is a complex and multidimensional concept. It implies the acceptance of illness, the need long-term treatment, recognition of symptoms as an integral part of disease and impaired social functioning. Enhancing insight into mental illness is the goal of any therapy. However, insight in schizophrenia can lead to negative consequences, especially when we talk about patients with the pronounced security measure of compulsory psychiatric treatment. Aims Acceptance of disease and critical attitude toward the criminal offense caused by depressed mood in patients, decrease motivation, feeling of worthlessness and low self-esteem. At this stage of treatment risk of suicide is increased. Method The retrospective study included 112 patients diagnosed with schizophrenia with the pronounced security measure of compulsory psychiatric treatment who committed criminal offences within or outside the family in the period from 2006. to 2010. The research investigated the connection of insight and a better therapeutic response, and on the other side the connection between insight and its negative consequences on the treatment. Results Insight in younger patients, with criminal offense within the family and previous treatment causes depression, self-stigma, feeling of worthlessness and suicidal ideation. Poor insight reduces the risk of depression and suicidal tendencies, but increases the number of hospitalizations and reduced social functioning. Conclusion Insight in schizophrenia favorable impacts on treatment and social functioning. But in this specific group of patients it seems that criminal offense, forced hospitalization and social isolation significantly influence the occurrence of depression, negative self-assessment and the risk of suicide.