Original ArticlesInsight Into Illness and Defense Styles in SchizophreniaOgawa, Yasuhiro MS∗,†; Fukuhara, Keita PhD∗; Tanaka, Hiroyuki PhD∗; Nagata, Yuma PhD∗; Ishimaru, Daiki MS∗; Nishikawa, Takashi MD∗Author Information ∗Department of Clinical Rehabilitation, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino City †Department of Rehabilitation, Hokutokai Sawa Hospital, Osaka, Japan. Send reprint requests to Takashi Nishikawa, MD, Department of Clinical Rehabilitation, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino City, Osaka 5838555, Japan. E-mail: [email protected]. The Journal of Nervous and Mental Disease: October 2019 - Volume 207 - Issue 10 - p 815-819 doi: 10.1097/NMD.0000000000001038 Buy Metrics Abstract Although the psychological denial model argues that poor insight is a result of defense mechanisms, the direct relationship between the two remains unclear. This study aimed to examine the relationship between insight into illness and defense mechanisms while considering cognitive dysfunction in schizophrenia. A total of 38 patients with schizophrenia were evaluated for level of insight (Schedule for the Assessment of Insight), defense mechanisms (Defense Style Questionnaire), neurocognitive function (Brief Assessment of Cognition in Schizophrenia), and psychotic symptoms (Brief Psychiatric Rating Scale). Regarding level of insight, partial correlation analysis controlling neurocognitive and psychotic variables showed that “recognition of illness” was positively correlated with immature defense styles and negatively correlated with mature defense styles. Stepwise regression analyses revealed that “recognition of illness” was significantly predicted by immature defense styles. Our findings suggest that patients who tend to use immature defense styles are more likely to accept their own mental illness. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.