Schizophrenia Research Trends

164M. Nieznański, A. Chojnowska, W. Duński, M. Czerwińska and S. Walczakeffectiveness of these interventions on illness awareness was assessed and the influenceof verbal learning abilities on insight change was explored and discussed.INTRODUCTIONMany research findings have reported stable and significant memory deficits inschizophrenia [cf. Aleman et al., 1999]. These deficits appear to encompass various memorysystems and components, including sensory, short-term (or working), long-term, declarative,and procedural memory, etc. [cf. Schröder et al., 1996; Stip and Lussier, 1996]. Relationshipsbetween memory impairments and other aspects of psychopathology in schizophrenia havebeen intensively studied in recent decades. The findings of these research are ofteninconsistent but mostly they suggest that verbal memory is connected with negative anddisorganization symptoms but not with hallucinations and delusions. Moreover, recent metaanalysishave pointed out the role of moderating factors, especially illness duration andgender, that can substantially affect relationships between symptoms and memory[Nieznański, 2004].The unawareness of illness has been regarded as a crucial factor in schizophrenia bymany clinicians and researchers. It seems to be the most common symptom of schizophrenia,and it occurs more often in schizophrenia than in other psychotic disorders. It is estimatedthat between 50 and 80 % of individuals with schizophrenia have poor insight regarding thefact that they have a mental disorder [cf. Amador and Gorman, 1998; Cuesta and Peralta,1994; Mintz, Dobson, and Romney, 2003]. In the last two decades, many research have beenfocused on understanding, defining, and measuring the unawareness of illness in psychoticdisorders. Most authors have concluded that it is a multidimensional phenomenon whichincludes at least three components: awareness of illness, awareness of the need for treatment,and recognition of signs of illness. The ability to attribute symptoms to disorder and tounderstand the social consequences of mental illness are often added to these dimensions [cf.Amador and David 1998; Cuesta and Peralta, 1994; David, 1990; Mintz, Dobson, andRomney, 2003].Unawareness of illness is assumed to have deleterious effects on treatment complianceand prognosis [cf. Lamot and Grzywa, 1997; McEvoy et al., 1989b; Smith et al., 1999a]. Thefindings regarding association between symptoms and insight are mixed. Some investigationshave demonstrated positive or inverse relationships between awareness of illness anddepressive symptoms [Carroll et al., 1999; Collins et al., 1997, Schwartz, 2001; Smith et al.,2000]. Other reports have suggested no significant association between insight and anysymptom group, especially acute psychopathology [Cuesta and Peralta, 1994; Kemp andDavid, 1996; McEvoy 1989a; Michalakeas et al., 1994]. However, many studies have shownthat poorer insight is related to more severe positive symptoms [Carroll et al., 1999; Collinset al., 1997, Kim et al., 1997; Lysaker et al., 1998; for review see: Mintz, Dobson, andRomney, 2003].