Awareness of being a patient and its relevance to insight into illness in patients with schizophrenia.

This article presents the development of the Awareness of Being a Patient Scale (ABPS), a 25-item self-report scale to measure the awareness of schizophrenic patients. Awareness is defined in terms of a patient's psychological attitude toward the psychiatric situation, and is to be evaluated from the standpoint of Parsons' sick-role concept by assessing the recognition of the need for treatment and acceptance of the treatment situation. It is hypothesized that awareness is a factor in the motivation to receive treatment. Closely related to the awareness is the insight into illness, a clinical construct comprising a patient's understanding of psychotic illness and symptoms. There also seems to be an overlap between them. However, the difference is that awareness principally pertains to a patient's perspective, not addressing the precise understanding of illness and symptoms, while the frame of reference in assessing insight is from the viewpoint of psychiatry. In examining properties of the ABPS, it is demonstrated that the ABPS has satisfactory reliability, favorable concurrent validity, and significant value in discriminating between long-term stable outpatients and recently admitted and long-term hospitalized patients. This study indicates that the awareness of being a patient has clinical importance and the ABPS is an efficient means of measuring such awareness.