The paradoxical role of insight in mental illness: The experience of stigma and shame in schizophrenia, mood disorders, and anxiety disorders

This study examined the factor structure of the Hungarian version of the Birchwood Insight Scale (BIS) and analyzed its association with socio-demographics, diagnosis, internalized stigma, and shame using confirmatory factor analysis (CFA) with covariates. Mentally ill patients (N = 200) completed self-report questionnaires. CFA supported a two-factor structure. While previous hospitalizations and diagnosis were associated with insight, insight predicted higher internalized stigma and shame. Efforts to increase insight should be matter of importance in the wider spectrum of mental diagnoses. However, such efforts should be conducted with special care as further research is needed to understand the impact of insight on wellbeing. •The factor structure of The Birchwood Insight Scale (BIS) has been little studied.•Confirmatory factor analysis showed the BIS had a two-factor structure.•Poor illness awareness is common among wide range of diagnoses.•The lowest illness awareness was observed in schizophrenia patients.•Higher illness awareness predicted higher internalized stigma and shame.