Predictive value of insight for suicide, violence, hospitalization, and social adjustment for outpatients with schizophrenia: A prospective study

This prospective study explores the predictive value of insight for suicide, violence, hospitalization, and social adjustment for a group of schizophrenic outpatients over 1 year. The Schedule of Assessment of Insight (SAI) and its expanded version (SAI-E) were used to provide a baseline insight score for 74 schizophrenic outpatients considered to be in remission or to have minimal psychopathology. Subjects were reassessed at the end of the period to determine the predictive value of initial insight rating by comparison. Insight into treatment was associated with less hospitalization and better social adjustment, but insight into mental illness or psychotic experience was not. It was also found that insight could neither predict suicidal behavior or violent tendencies. Therefore, some dimension of insight may predict hospitalization and social adjustment in schizophrenics, although its predictive efficacy for other clinical outcomes and behaviors may be limited.