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Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies

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Abstract

Poor insight exists in all phases of schizophrenia and is associated with poor clinical prognosis and adverse psychosocial functioning. This is a meta-analysis examining the prevalence of poor insight and its correlates in Chinese patients with schizophrenia. Both major international (PubMed, EMBASE, PsycINFO, and Web of Science) and Chinese (WANFANG and CNKI) databases were systematically searched. The pooled prevalence of poor insight was calculated using the random-effects model. A total of 19 studies with 3112 schizophrenia patients were included. The prevalence of poor insight was 43.4% (95%CI: 36.0%–51.2%). Subgroup and meta-regression analyses revealed that the higher prevalence of poor insight was significantly associated with single-site design, smaller sample size, inpatient status, acute illness phase, higher male proportion, younger age, shorter duration of illness, lower study quality, and earlier publication year. Poor insight is common in Chinese schizophrenia patients. Considering the negative outcomes of poor insight, regular screening and effective psychosocial interventions should be delivered for this vulnerable population.

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Funding

The study was supported by the National Science and Technology Major Project for investigational new drug (2018ZX09201–014), the Beijing Municipal Science & Technology Commission (No. Z181100001518005), and the University of Macau (MYRG2019–00066-FHS).

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Author notes

  1. Wen Li, Hong-He Zhang, Yu Wang and Ling Zhang contributed equally to this work.

Authors and Affiliations

  1. Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China

    Wen Li & Yu-Tao Xiang

  2. Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China

    Hong-He Zhang

  3. Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China

    Yu Wang

  4. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China

    Ling Zhang

  5. Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia

    Gabor S. Ungvari

  6. University of Notre Dame Australia, Fremantle, Australia

    Gabor S. Ungvari

  7. School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR, China

    Teris Cheung

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  7. Yu-Tao Xiang
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Study design: Wen Li, Yu-Tao Xiang. Data collection, analysis and interpretation: Wen Li, Hong-He Zhang, Yu Wang, Ling Zhang. Drafting of the manuscript: Wen Li, Hong-He Zhang, Yu Wang, Yu-Tao Xiang. Critical revision of the manuscript: Gabor S. Ungvari, Teris Cheung. Approval of the final version for publication: all co-authors.

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Correspondence to Yu-Tao Xiang.

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Li, W., Zhang, HH., Wang, Y. et al. Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies. Psychiatr Q 91, 1017–1031 (2020). https://doi.org/10.1007/s11126-020-09786-7

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