Relative contributions of psychotic symptoms and insight to quality of life in stable schizophrenia

The purpose of this study was to examine the relative contributions of psychotic symptomatology such as delusions and hallucinations, and insight to quality of life (QOL) in a sample of outpatients with stable schizophrenia. Eighty-three consecutive outpatients with stable schizophrenia were enrolled in a cross-sectional study. We performed a path analysis using a multiple regression technique to assess the specific effect of psychotic symptomatology on QOL and the possible mediating role of insight. Our findings suggested that (i) psychotic symptomatology was negatively correlated to both QOL and the two dimensions of insight we considered (awareness of symptoms and attribution of symptoms); (ii) the impact of insight on QOL was not uniform as attribution of symptoms positively predicted QOL, while the effect of symptom awareness was negative; (iii) when the mediation effect of insight was taken into account, psychotic symptomatology was no longer a significant predictor of QOL on its own. These results suggested a complex pattern of relationships between different dimensions of insight, QOL and psychotic symptomatology. Different dimensions of insight could be related to different aspects of outcome, and this would need to be reflected in rehabilitation programs.