Objective: Although several neuropsychological studies have supported the n
otion of frontal and parietal lobe involvement in unawareness of illness in
schizophrenia, neuroanatomic differences have not been examined.
Method: Thirty patients with schizophrenia spectrum disorder were rated by
means of a structured interview assessing awareness of illness and performa
nce on clinical rating scales. With 13 healthy comparison subjects, they un
derwent neuropsychological assessment and a scan using three-dimensional, s
poiled gradient recall acquisition volumetric magnetic resonance imaging.
Results: Patients who were relatively unaware of their illness had smaller
brain and intracranial volumes (brain tissue plus CSF) than either aware pa
tients or normal comparison subjects, who did not differ significantly from
each other.
Conclusions: These findings suggest that unawareness of illness is an impor
tant phenomenological feature with neurological correlates that is seen in
at least one subgroup of patients with schizophrenia.