Awareness of illness in schizophrenic, schizo-affective, bipolar and unipolar mood disorders; results of a comparative study of 90 hospitalized patients.

Brought-up by alienists long ago, the question of awareness of illness has once again struck psychiatrists because of its diagnostic and therapeutic implications. As we now dispose of dependable psychometric tools, using Amador's Scale to assess Unawareness in Mental Disorders, we have evaluated a cohort of 90 patients presenting with the following DSM-IV diagnoses: 37 suffered from schizophrenia with psychotic symptoms (PS), 14 from a schizo-affective disorder with PS, 18 from bipolar disorder with PS, seven from unipolar disorder with PS and 14 from unipolar disorder without PS. Statistical analysis of results allowed to confirm that awareness of illness was significantly weaker in patients suffering from schizophrenia. Furthermore, causal attribution of symptoms and social consequences of disorder are significantly less correct in these patients. Finally, these results reflect those of recent studies by Bebbington and White on social context of insight. Is poor insight in certain mental disorders a symptomatic dimension or is it linked to social and cultural differences between the patient and his/her therapist? (C) 2001 Editions scientifiques et medicales Elsevier SAS.