Reduced awareness of illness in first-episode psychosis

We sought to investigate whether first-episode and multiple-episode patient s differ in their awareness of their illness. A total of 312 multiple-episo de and 144 first-episode patients participated, the majority of whom had a schizophrenia spectrum disorder (schizophrenia or schizophreniform disorder ). Insight was measured using the Scale for the Assessment of Unawareness o f Mental Disorder (SUMD). First-episode patients with a schizophrenia spect rum disorder were less aware of having a mental illness than multiple-episo de patients. Our findings suggest that in the time following the first epis ode of psychosis, patients may become less defensive, and possibly more ski lled in using medical terms to describe their illness. We suggest a need fo r skilled psychoeducation that addresses awareness in patients with psychos is, particularly those who are unaware of their illness, Copyright (C) 2001 by W.B. Saunders Company.