BACKGROUND Suicidal behavior is highly prevalent in schizophrenia. Among the risk factors, insight has been little studied and has yielded contradictory results. In addition, it has been studied neglecting relevant psychological aspects, such as beliefs about illness and coping styles. METHOD We assessed 133 outpatients diagnosed with schizophrenia according to ICD-10 criteria. Evaluation included sociodemographic, general clinical, psychopathological, psychological and suicidal behavior variables. RESULTS Neither insight nor insight coupled with negative beliefs and/or coping styles were associated with suicidal behavior. Nevertheless, insight coupled with negative beliefs and/or coping styles was associated with greater hopelessness and depression, internalized stigma, worse control over illness and greater global severity as compared to insight coupled with positive beliefs and coping styles. Suicide attempt and suicidal ideation groups showed greater depression and hopelessness, worse global beliefs and worse control over illness, higher socio-economic level, and greater number of previous psychiatric admissions compared to the non-suicidal group. CONCLUSIONS Insight coupled with negative beliefs and/or coping style was not associated with suicidal behavior. Nevertheless, it was associated with greater depression and hopelessness, both of which are firmly established risk factors for suicide in schizophrenia. Prospective studies with long-term follow-up and large samples are needed to clarify this issue. Clinicians should assess these psychological features associated with insight, both in patients with insight and in those with poor insight when promoting it.

中文翻译：

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痛苦的洞察力与精神分裂症的可用洞察力。它们对自杀行为有不同的影响吗？

背景自杀行为在精神分裂症中非常普遍。在风险因素中，洞察力很少被研究，并且产生了相互矛盾的结果。此外，研究忽略了相关的心理方面，例如对疾病的信念和应对方式。方法 我们根据 ICD-10 标准评估了 133 名诊断为精神分裂症的门诊患者。评估包括社会人口学、一般临床、精神病理学、心理和自杀行为变量。结果 洞察力或洞察力加上消极信念和/或应对方式都与自杀行为无关。然而，洞察力加上消极信念和/或应对方式与更大的绝望和抑郁、内化的耻辱感、与洞察力加上积极的信念和应对方式相比，对疾病的控制更差，全球严重程度更高。与非自杀组相比，自杀未遂和自杀意念组表现出更大的抑郁和绝望、更糟糕的全球信念和更差的对疾病的控制、更高的社会经济水平以及更多的精神病入院次数。结论 洞察力加上消极信念和/或应对方式与自杀行为无关。然而，它与更严重的抑郁和绝望有关，这两者都是精神分裂症患者自杀的明确危险因素。需要长期随访和大样本的前瞻性研究来澄清这个问题。临床医生应评估这些与洞察力相关的心理特征，