Well-informed but not aware: The P.A.C.T.® psychoeducation program for schizophrenia improves knowledge about, but not insight into, the illness

Asian J Psychiatr. 2019 Dec:46:15-18. doi: 10.1016/j.ajp.2019.09.034. Epub 2019 Sep 27.

Abstract

Background: Most individuals with schizophrenia (SZ) have little to no insight regarding the presence of their illness. Psychoeducational programs are state-of-the-art interventions that consist in delivering stabilized patients with accurate knowledge about their illness and its treatment. Evidence suggests a significant relationship between levels of illness-related knowledge and insight in SZ patients. However, the effect of psychoeducation on these related outcomes needs to be explored further.

Methods: In this open label study involving 30 French-speaking patients with SZ, we propose to compare levels of knowledge and insight before and after the French P.A.C.T.® psychoeducation program to investigate how this approach affects both outcomes. Knowledge levels were measured with the self-questionnaire "What do I know?". Insight levels were measured using the Scale to Assess Unawareness of Mental Disorder (SUMD). Symptoms were assessed with the Positive And Negative Syndrome Scale (PANSS).

Results: A large significant improvement of knowledge was observed (p < 0.001; d = 0.77). By contrast, the analysis reported no significant effect of psychoeducation on insight (p = 0.86; d = 0.07). PANSS total scores were significantly decreased after treatment (p = 0.001; d = 0.66).

Conclusions: Although the P.A.C.T.® program is a promising tool for improving illness-related knowledge in SZ patients, its use is not sufficient to significantly improve insight levels.

Keywords: Cognition; Insight; Knowledge; Psychoeducation; Schizophrenia.

MeSH terms

  • Adult
  • Awareness / physiology*
  • Diagnostic Self Evaluation*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Patient Education as Topic*
  • Schizophrenia / physiopathology*
  • Treatment Outcome