Schizophrenia patients with less insight into their symptoms had thinner cortical thickness in the right insular cortex than did patients with greater insight, according to Seema Emami and associates.

Ms. Emami recruited 67 patients aged 18-50 with schizophrenia from clinics at the Douglas Mental Health University Institute in Montreal. The patients were assessed using two instruments – the Scale for Assessment of Positive Symptoms and the Scale for the Assessment of Insight – Expanded. Cortical thickness data were assessed using MRI.

Compared with a healthy control group, schizophrenia patients with less insight into symptoms (IS) had thinner right insular cortex than patients with greater IS. Patients with greater IS showed “cortical thickness differences only in the right inferior temporal cortex and right anterior cingulate gyrus,” the investigators wrote.

No difference between patient groups was found in the frontal lobe region or the superior temporal gyrus on either hemisphere. Small correlations were observed between illness insight and thinner cortex in the right parahippocampal gyrus, and in awareness of need for treatment and thinner cortex in the left cuneus and right parahippocampal gyrus.

“Better measurement and understanding of symptom awareness, as well as development of insight remediation therapies, may aid clinicians in improving therapeutic cooperation and contribute to reduced treatment noncompliance,” the investigators noted.

Find the full study in Schizophrenia Research (doi: 10.1016/j.schres.2015.10.016).