Self-Stigma and Insight Affect Life Satisfaction in Schizophrenia

Possessing a high level of insight into one's disorder can negatively affect life satisfaction in schizophrenia.

When self-stigma content is high among patients with schizophrenia, possessing a high level of insight into one’s disorder can negatively affect life satisfaction, according to study findings published in Schizophrenia Research.

In this study, investigators enrolled 181 patients with schizophrenia spectrum disorders who were receiving outpatient treatment from 5 public specialty clinics and 6 mental health service organizations in Hong Kong. Of these patients, 130 and 110 completed both a 6-month and 1-year follow-up assessment, respectively, that compared baseline insight and self-stigma with life satisfaction.

For the study, self-stigma content referred to the intellectual and emotional meaning patients attributed to their disorder, whereas insight referred to the awareness patients had regarding their illness as well as its symptoms, consequences, and medication effects.

Investigators found a significant moderating effect of self-stigma content (β, −0.15; t, −1.99; P <.05), as well as the self-stigma process (β, −0.19; t, −2.50; P <.05), on predicting life satisfaction at 6-month follow-up.

According to findings from simple slope tests, insight at baseline was significantly associated with lower 6-month life satisfaction in the presence of high self-stigma content (slope, −0.27; t, −3.03; P <.01) or in the presence of high self-stigma process (slope, −0.03; t, −3.4; P =.001). In addition, when self-stigma process was 1 standard deviation below the mean, insight at baseline was associated with significantly better life satisfaction at 1 year (slope, 0.32; t, 2.97; P <.01).

Related Articles

The findings from this study may not necessarily be applicable to inpatients with schizophrenia, considering only outpatients were recruited. In addition, the findings may only be applicable to older patients with shorter illness durations, as most of the patients who dropped out of the study by 6 months were generally younger and suffered from a longer disease duration.

In regard to insight, there is a great need for healthcare providers to focus not only “on facilitating people on the acceptance of the illness label, they should facilitate the people in recovery to continuously process and make sense of their illness experience and develop a positive sense of the self that goes beyond patienthood.”


Chio FHN, Mak WWS, Chan RCH, Tong ACY. Unraveling the insight paradox: One-year longitudinal study on the relationships between insight, self-stigma, and life satisfaction among people with schizophrenia spectrum disorders [published online February 3, 2018]. Schizophr Res. doi: 10.1016/j.schres.2018.01.014