Insight and Physical Health in Schizophrenia: Discrepancies Between Subjective and Objective Health Indicators

It is well established that individuals with schizophrenia experience substantially poorer physical health and reduced life expectancy compared to the general population, yet the psychosocial mechanisms that may be contributing to these disparities remain a developing field of literature, with the prominent factors being health literacy, structural barriers, and physician bias. While prior research has documented impairments in insight across domains such as cognition, functioning, and psychiatric health, it is unclear whether such deficits extend to physical health. The present study examined whether individuals with schizophrenia demonstrate reduced correspondence between subjective self-reported health and objective health indicators. Adults diagnosed with schizophrenia (n = 46) and healthy controls (n = 48) were recruited from the Chicago community. Self-reported health was assessed using RAND-36 subscales of General Health, Role Limitations, and Bodily Pain, while objective health was operationalized using BMI, blood pressure, and number of medical conditions. Participants with schizophrenia (PSZ) had significantly more medical conditions and higher diastolic blood pressure, as well as poorer self-reported health across all domains. Across the full sample, a greater number of conditions were associated with poorer self-reported health; however, within-group analyses demonstrated limited significant association, and no differences in the strength of these relationships between groups. Regression analyses further indicated that diagnosis did not moderate these relationships. Contrary to hypotheses, individuals with schizophrenia demonstrated generally accurate self appraisal, suggesting that insight deficits may be domain-specific rather than generalized.