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SUMMARY:What is poor  insight into illness in schizophrenia? - Dr Mads Gra
 m Henriksen\, Centre for Subjectivity Researcg\, University of Copenhagen
DTSTART:20131010T113000Z
DTEND:20131010T123000Z
UID:TALK47933@talks.cam.ac.uk
CONTACT:Dr James Kirkbride
DESCRIPTION:Poor insight into illness is considered the primary cause of t
 reatment noncompliance in schizophrenia. Yet\, the complexity of the pheno
 menon of poor insight is\, in my view\, not well understood\, and we are s
 till short of solid answers to the most basic questions: why do many patie
 nts with schizophrenia not feel ill in the sense of attributing their abno
 rmal experiences to this mental disorder\, and what is poor insight into i
 llness really? These are the central questions\, which the presentation ra
 ises and strives to provide preliminarily answers to. The presentation has
  two parts. In the first part\, I will discuss the definition(s) of poor i
 nsight\, review the available results from empirical studies\, and discuss
  the predominant conceptual accounts of poor insight (which consider it as
  an ineffective self-reflection\, caused either by psychological defences 
 or impaired metacognition). I will argue that these accounts are at odds w
 ith the phenomenology of schizophrenia-according to which schizophrenia is
  a specific disorder of the self that involves a variety of alterations of
  the structures of experiencing that affects the very conditions of self-r
 eflection. In the second part\, I will propose a phenomenologically orient
 ed account of poor insight in schizophrenia. I will try to argue that the 
 reason why most schizophrenia patients have no or only partial insight and
  consequently do not comply with treatment is rooted in the nature of thei
 r (non-psychotic) anomalous self-experiences (i.e. self-disorders) and the
  related articulation of their psychotic symptoms. More specifically\, I w
 ill argue that self-disorders destabilize the patients' experiential frame
 work\, thereby weakening their basic sense of reality ("natural\nattitude"
 ) and enabling another sense of reality ("solipsistic attitude") to emerge
  and coexist. This co-existence of attitudes\, which Bleuler termed "doubl
 e bookkeeping"\, is\, in my view\, central to understanding what poor insi
 ght in schizophrenia really is.
LOCATION:Block 14\, Ida Darwin
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