THE CONTRIBUTION OF DEPRESSION AND DENIAL TOWARDS UNDERSTANDING THE UNAWARENESS OF SYMPTOMS IN SCHIZOPHRENIC OUT-PATIENTS

Objectives. Unawareness of schizophrenic symptoms was postulated to be partially attributable to patients denying symptoms in order to avoid depression. Method. The 24-item version of the Brief Psychiatric Rati ng Scale (BPRS) was administered to 41 schizophrenic patients (chart d iagnoses were validated by a DSM-III-R checklist). The first 14 of the se items were then used to gather information about patients' symptoma tology from 55 relatives of patients. Unawareness of symptoms was calc ulated by subtracting patients' total for these 14 items from parents' totals. Two measures of depression were obtained. Subjective depressi on was the score on the depression item based on patients responses to interview questions, objective depression was the score based on inte rviews with relatives about their ill family member. Family functionin g was also assessed by administering patients' relatives the Camberwel l Family Interview and the FACES III. Results. Hierarchical regression analyses revealed that both subjective and objective measures of depr ession were significantly related to unawareness; subjective depressio n was negatively related, and objective depression was positively rela ted. The employed measures of family functioning were unrelated to una wareness of symptomatology. Conclusion. This opposing pattern of subje ctive and objective depression was interpreted as evidence of the self -deception which characterizes all defence mechanisms including denial .