Original ArticlesInsight Into Illness and Psychological Defense Attitudes in People With Chronic Schizophrenia Using Markova's Insight ScaleOgawa, Yasuhiro PhD∗,†; Fukuhara, Keita PhD‡; Tanaka, Hiroyuki PhD§; Nagata, Yuma PhD∥; Ishimaru, Daiki PhD∥; Urakawa, Mizuki MS†; Nishikawa, Takashi MD‡Author Information ∗Faculty of Health Sciences, Morinomiya University of Medical Sciences †Department of Rehabilitation, Hokutokai Sawa Hospital, Osaka ‡Faculty of Health Sciences, Naragakuen University, Nara §Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation ∥Department of Psychiatry, Course of Integrated Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan. Send reprint requests to Yasuhiro Ogawa, PhD, Faculty of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16 Nankokita, Suminoe-ku, Osaka-City, Osaka 5598611, Japan. E-mail: [email protected]. The Journal of Nervous and Mental Disease: December 2021 - Volume 209 - Issue 12 - p 879-883 doi: 10.1097/NMD.0000000000001392 Buy Metrics Abstract Insight into illness is a multidimensional phenomenon, and various assessments are available. We focused on Markova's Insight Scale (IS) and investigated the relationship between insight, psychological defenses, and neurocognition in 38 patients with schizophrenia. Results showed that insight was significantly correlated with an immature defense style. Moreover, IS was significantly predicted by immature defense style after adjusting for clinical variables. Although insight is often assumed to be multidetermined with potential contributions from factors such as cognitive function and psychological defensive mechanisms, our results indicated that better insight assessed with the IS is more likely to reflect immature defenses. This may also be reflected in our result that a higher insight score correlated with earlier onset of illness. The insight score may reflect the immature psychological defensive attitudes of schizophrenia and may lead such patients to wish to comply with the views of clinicians. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.