Unawareness in schizophrenia: neuropsychological and neuroanatomical findings

Psychiatry Clin Neurosci. 2006 Oct;60(5):531-7. doi: 10.1111/j.1440-1819.2006.01576.x.


The lack of insight in schizophrenia has so far been interpreted as a primary symptom of the illness, namely a defensive mechanism rather than a neurologically-based condition. However, recent findings have emphasized its relationship with damage to specific brain areas as well as the domain specificity in which it may occur. This supports a neuropsychological interpretation of the lack of insight in schizophrenia. The present article reviews the foregoing data, and takes into account the most relevant anatomo-clinical results. There is evidence that the lack of insight in schizophrenia may occur as a neurological disease per se following brain damage that seems related to frontal lobe areas. Additionally, it could either be related to all aspects of the disease or be domain-specific, occurring for one kind of symptom but not for others. These data indicate several analogies with the phenomenon called anosognosia for a neurological deficit.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Awareness / physiology*
  • Brain / pathology
  • Dyskinesia, Drug-Induced
  • Humans
  • Schizophrenia / complications
  • Schizophrenia / pathology*
  • Schizophrenic Psychology*