ORIGINAL ARTICLESInsight and its relationship to clinical outcomes in patients with schizophrenia or schizoaffective disorder receiving long-acting risperidoneGharabawi, Georges M.a; Lasser, Robert A.a; Bossie, Cynthia A.a; Zhu, Younga; Amador, XavierbAuthor Information aMedical Affairs, Janssen Pharmaceutica Inc., Titusville, New Jersey bColumbia University, New York, New York, USA Correspondence and requests for reprints to Dr Georges M. Gharabawi, Group Director, Psychiatry, Medical Affairs, Janssen Pharmaceutica Inc., 1125 Trenton-Harbourton Road, Titusville, NJ 08560, USA Tel:+1 609 730 3277; e-mail: GGharaba@JANUS.JNJ.com Received 26 October 2005 Accepted 24 January 2006 International Clinical Psychopharmacology: July 2006 - Volume 21 - Issue 4 - p 233-240 Buy Abstract Poor insight is common in schizophrenia, predictive of non-compliance, and an impediment to effective patient management. We hypothesized that long-acting risperidone would be associated with enhanced insight, contributing to improved quality of life measures. In an international, open-label 50-week study, stable patients received long-acting risperidone every 2 weeks. Assessments included the Positive and Negative Syndrome Scale [PANSS; item G12 rated ‘impaired insight and judgment’ from 1 (no impairment) to 7 (severe impairment)]; Clinical Global Impressions-Severity (CGI-S); and the Medical Outcomes Study Short-form 36-item Health Survey (SF-36) (patient-rated quality of life). Correlation and regression post-hoc analyses examined associations between insight and other measures. At baseline, 314 (51.1%; N=614) patients had impaired insight (G12=3−7) and 83 (26.4%) achieved normal or near normal ratings at endpoint (G12=1−2). Symptom severity corresponded with insight: baseline mean±SD PANSS total scores were 56.0±14.4 in patients without impaired insight (G12=1−2); 73.4±15.7 with mild-moderate impairment (G12=3−4); and 86.0±17.4 with severe impairment (G12=5−7). These scores improved significantly in each group at endpoint (P<0.001). Improved insight ratings correlated with improvements in CGI-S (r=0.37); PANSS disorganized thought (r=0.46); negative symptoms (r=0.32); and anxiety/depression (r=0.24; P<0.001 all comparisons), but not quality of life ratings. The change in insight did not contribute significantly to the variance in SF-36 scores; however, changes in negative symptoms, anxiety/depression and CGI-S scores did contribute significantly. Long-acting risperidone was associated with improvements in insight, symptom domains, clinical status and quality of life measures. Associations were noted between patient-rated quality of life and specific symptom domains, but not insight. © 2006 Lippincott Williams & Wilkins, Inc.