Investigation of insight formation using narrative analyses of people with schizophrenia in remission

Poor insight in schizophrenic patients is a common and multidimensional phenomenon. The purpose of this study was to explore the process of the formation of insight in patients with schizophrenia in remission. A qualitative design was used to analyze first-person narratives of 50 people with schizophrenia in remission. Face to face, semistructured interviews were conducted by investigators, and the narratives were transcribed verbatim. The results of our study showed that there were four stages of illness understanding in patients with schizophrenia: 1) the feeling that symptoms were unbearable or a loss of control, 2) comparisons of experiences with references, 3) perception that medication was working through trial and error experiments, and 4) awareness of illness after medication relieved symptoms. Insight formation is an active process in which schizophrenic patients gain knowledge about their medication, connect the association between their medication and symptoms, and realize they need to deal with issues.