Relationship of awareness of dyskinesia in schizophrenia to insight into mental illness

Objective: The purpose of this study was to determine whether lack of aware ness of motor dysfunction and lack of insight into mental dysfunction are r elated and to evaluate the longitudinal stability of lack of awareness of a bnormal movements in schizophrenia. Method: Forty-three patients with schiz ophrenia and tardive dyskinesia participated in the study. The Scale of Una wareness of Mental Disorder was used to assess insight. All patients still meeting inclusion criteria after 2 years (N=16) were reevaluated at follow- up. Results: Twenty (46.5%) of the 43 patients had at least moderate unawar eness of their tardive dyskinesia. Awareness of tardive dyskinesia was only modestly related to two of the five dimensions of insight into mental diso rder assessed. Patients with the deficit syndrome showed significantly less awareness of their tardive dyskinesia than patients without the deficit sy ndrome. Lack of awareness of tardive dyskinesia was stable over time. Concl usions: Lack of awareness of tardive dyskinesia is a common feature in schi zophrenia and is stable over time. Since patients are often unaware of dysk inesia, direct clinical examination is required to identify early tardive d yskinesia.