The relationship between insight and medication adherence in severely mentally ill clients treated in the community

Objective: To study the relationship between aspects of insight and medication adherence and elements of psychopathology. Method: Clients completed insight and adherence measures in interview; doctors and case managers independently completed ratings of adherence and psychopathology. Other client information was obtained from the clinical file. Results: The subscale structure of the insight scale was well reproduced. Clients endorsed items relating to need for treatment more than items. relating to relabelling of symptoms and awareness of illness. Self-reported insight was lower in those clients for whom either the treating doctor or the case manager or both thought the client was non-adherent. Insight was related positively to clinician ratings of depressed mood, and negatively to clinician ratings of personal functioning. Conclusion: Our data support the subscale structure of the insight questionnaire used, and previous suggestions that insight it; positively related to depressive affect, and inversely related to impaired psychosocial functioning.