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Effect of Video Self-Observations vs. Observations of Others on Insight in Psychotic Disorders

David, Anthony S. MD*; Chis Ster, Irina PhD, MRC; Zavarei, Hooman MD*

The Journal of Nervous and Mental Disease: April 2012 - Volume 200 - Issue 4 - p 358–361
doi: 10.1097/NMD.0b013e31824cc443
Brief Reports

Improving insight in patients with schizophrenia and related disorders is a worthwhile goal. Previous work has suggested that patients’ insight may improve if they see videos of themselves taken when ill. Our aim was to test the hypothesis that schizophrenia patients improve their insight after viewing videos of themselves when unwell more so than after viewing an actor. Forty patients admitted with an acute psychotic disorder underwent a videotaped recording of a clinical interview. The patients were then randomized to viewing this or a “control” video of a same-sex actor displaying psychotic symptoms approximately 3 weeks later. Insight, psychopathology, and mood were assessed before and 24 to 48 hours after viewing the videos. All participants showed general improvement across all measures. There was a trend for scores on the Schedule for the Assessment of Insight to improve more in those who viewed themselves when ill, but there were no clear statistically significant differences between the “self” and “other” video groups. In conclusion, video self-confrontation seems to be a safe and potentially effective means of enhancing insight, but evidence for a specific effect is lacking.

*Institute of Psychiatry, King’s College London, London, United Kingdom; and †Centre for Paediatric Epidemiology and Biostatistics, University College London, London, United Kingdom.

Send reprint requests to Anthony S. David, MD, Section of Cognitive Neuropsychiatry, PO Box 68, Institute of Psychiatry, King’s College London, DeCrespigny Park, London, SE5 8AF, UK. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.