Cognitive correlates of lack of judgment and insight in patients with paranoid schizophrenia: methodology and research program

The article emphasizes a vagueness in scientific views and assessment tools common in Russian psychology and psychiatry about lack of judgement and insight phenomenon. The approach justifies a necessity to improve psychological assessment of lack of judgement and insight in patients with paranoid schizophrenia, taking into account the emergence of new scientific data and theories, in particular the concepts of cognitive deficit and metacognitive functions. For this reason, the method of assessment of lack of judgment and insight is justified using, among others, the quantitative indicators of cognitive functions. There are 90 patients of mental hospital diagnosed with paranoid schizophrenia examined by now. Using a semi-structured interview, the characteristics of lack of judgment, anosognosia and incorrect self-awareness were obtained in these patients, as well as their attitude to erroneous decisions. Using clinical scales (values were verified by psychiatrist), the social performance and symptoms severity were evaluated. The cognitive performance was assessed by number of neuropsychological tools. Also, a brief neuropsychological monitoring was used to exclude patients with organic pathology. An attempt is made to experimentally evaluate cognitive correlates of lack of judgment and insight (understood as metacognitive function, as ability to recognize and correct erroneous decisions) in patients with paranoid schizophrenia by means of a comprehensive analysis of the patient's erroneous decisions, their attitude to them and characteristics of cognitive deficit.