Evidence has begun to accumulate which suggests that lack of awareness of illness in schizophrenia is related to and possibly the result of a cognitive deficit involving prefrontal cerebral dysfunction. This study further explores this relationship along with other domains of self-awareness in chronic schizophrenics and other subjects with serious mental disorders. One hundred eight schizophrenics and 21 bipolar subjects from three separate sites in Britain, Germany, and Canada were administered the Wisconsin Card Sorting Test and three measures of self-awareness. Lack of illness awareness and other domains of self-knowledge were significantly more related to poorer neuropsychological performance in schizophrenia patients than in the other subjects. The results support the hypothesis that lack of illness awareness is related to defective frontal lobe functioning as indexed by neuropsychological measures.
1 Queen Street Mental Health Center, Toronto, Ontario, Canada.
2 York University, Department of Psychology, Toronto, and Baycrest Center for Geriatric Care, Department of Psychology, Toronto, Ontario, Canada.
3 Ontario Institute for Studies in Education, Toronto, Ontario, Canada.
4 Wuppertal University, Department of Psychology, Wuppertal, Germany.
Send requests for reprints to Dr. Donald A. Young, Archway Clinic, c/o Queen Street Mental Health Centre, 1001 Queen Street West, Toronto, Ontario, M6J 1H4, Canada.
The authors thank the clinical staff at The Archway Clinic and Queen Street Mental Health Center for their kind assistance. Appreciation is expressed to three anonymous reviewers from The Journal of Nervous and Mental Disease for their critiques and comments on an earlier draft of this manuscript. This research was funded by the Archway Advisory Board.