Table of ContentsView AllTable of ContentsDefinitionCausesSymptomsDiagnosisTreatmentHow to Help
Table of ContentsView All
View All
Table of Contents
Definition
Causes
Symptoms
Diagnosis
Treatment
How to Help
When someone isn’t aware they’re experiencing symptoms, they don’t recognize the need for treatment, leading to worse health outcomes and overall prognosis.
This article will discuss anosognosia, including its causes, symptoms, and treatment in this overview.
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Anosognosia Definition
The word “anosognosia” has Greek roots and roughly means “to not know a disease.”
Someone living with anosognosia may not be aware they have an illness and need treatment.They might doubt their diagnosis, attribute signs and symptoms to other causes, or sincerely believe they don’t need help. They may not want to discuss their health or may become defensive when someone brings it up.
A Word From VerywellAnosognosia is different than denial and commonly occurs as the result of damage to the frontal lobe and/or mental illness. A thorough medical evaluation can help distinguish between these causes and provide more targeted management of the symptoms.—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
A Word From Verywell
Anosognosia is different than denial and commonly occurs as the result of damage to the frontal lobe and/or mental illness. A thorough medical evaluation can help distinguish between these causes and provide more targeted management of the symptoms.—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
Anosognosia is different than denial and commonly occurs as the result of damage to the frontal lobe and/or mental illness. A thorough medical evaluation can help distinguish between these causes and provide more targeted management of the symptoms.
—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
What Causes Anosognosia?
Awareness and insight have been linked to a person’s ability to observe and organize new information about themselves, reflect on their own thoughts, and recognize the changes in themselves.If the frontal lobe doesn’t recognize the symptoms of an illness, the person is left with the pre-illness self-image and a lack of insight into their current health status.
Brain injury and damage can also cause a person to lose awareness and insight. This can occur when brain lesions cause damage to one side of the brain orwhen a stroke is experiencedand the person loses awareness on the recovering side of their body.
Associated ConditionsSeveral health conditions are linked to structural or functional brain differences or damage to the frontal lobe. Damage to the frontal lobe can cause many problems with thinking and cognition, including the lack of self-awareness that can cause anosognosia. These include:Mood disorders like major depressive disorder (MDD) and bipolar disorderand psychotic disorders like schizophreniaCognitive and neurological conditions likeAlzheimer’s disease and dementia(memory impairment and decline)Huntington’s disease and Parkinson’s diseasePsychosocial factors, including personality, beliefs, values
Associated Conditions
Several health conditions are linked to structural or functional brain differences or damage to the frontal lobe. Damage to the frontal lobe can cause many problems with thinking and cognition, including the lack of self-awareness that can cause anosognosia. These include:Mood disorders like major depressive disorder (MDD) and bipolar disorderand psychotic disorders like schizophreniaCognitive and neurological conditions likeAlzheimer’s disease and dementia(memory impairment and decline)Huntington’s disease and Parkinson’s diseasePsychosocial factors, including personality, beliefs, values
Several health conditions are linked to structural or functional brain differences or damage to the frontal lobe. Damage to the frontal lobe can cause many problems with thinking and cognition, including the lack of self-awareness that can cause anosognosia. These include:
Anosognosia Symptoms
Anosognosia symptoms include:
Symptoms present in a range of ways. A person may be partially aware of their illness and symptoms or not at all.
When anosognosia is due to traumatic brain injury, for example, the person may not be able to retrieve new information to update their insight about symptoms, but when associated with psychiatric illness, the person may connect current symptoms to other causes.
Anosognosia differs from denial in the following ways:
PrevalenceThe prevalence of anosognosia varies depending on the underlying cause. Based on early studies from the 1990s, the National Alliance on Mental Illness (NAMI) reports that approximately 30% of people with schizophrenia and 20% of people with bipolar disorder experienced a “severe” lack of awareness of their diagnosis.More recent research suggests an even higher prevalence of 57% to 98% in those withschizophrenia.
Prevalence
The prevalence of anosognosia varies depending on the underlying cause. Based on early studies from the 1990s, the National Alliance on Mental Illness (NAMI) reports that approximately 30% of people with schizophrenia and 20% of people with bipolar disorder experienced a “severe” lack of awareness of their diagnosis.More recent research suggests an even higher prevalence of 57% to 98% in those withschizophrenia.
Traumatic Brain Injury (TBI) Causes and Complications
How Anosognosia Is Diagnosed?
The steps for diagnosing anosognosia include consulting with a healthcare provider who can provide a thorough evaluation. If structural brain damage or traumatic brain injury is suspected, neuroimaging (taking scans of the brain) may be used as part of the diagnostic process.
If anosognosia is due to mental illness, a mental healthcare provider may use the Scale to Assess Unawareness in Mental Disorder (SUM-D) to measure:
Evaluation is about assessing functional impairment. The challenge is providing the healthcare professional with an accurate picture of functionality when awareness is compromised.
In theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5), anosognosia is not a condition on its own, but a symptom of other diagnosable conditions.
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How Anosognosia Is Treated
There is no standardized treatment for anosognosia or cure. Treatment methods are usually based on the underlying cause. They may include medication,psychotherapy (talk therapy) and counseling, and supportive intervention and strategies, or a combination approach.
Poor insight is associated with an increased likelihood of involuntary hospitalizations and use of emergency services.
Antipsychotic Therapy
If symptoms are linked to psychiatric conditions causing psychotic symptoms like psychosis, some research suggests takingantipsychotic medicationmay help reduce anosognosia and improve insight.
Medications to Treat Schizophrenia
Motivational Enhancement Therapy (MET)
Motivational enhancement therapy (MET) is typically used intreating alcohol use disorder. It’s a fast-paced form of therapy geared toward encouraging someone to make internally produced changes, meaning they change because they accept they need to and now want to.
Cognitive Behavioral Therapy (CBT) or Counseling
Psychotherapy can help those with anosognosia learn about their underlying illness and symptoms. Counselors and other mental health professionals may use one or more psychotherapy methods, includingcognitive behavioral therapyand supportive intervention strategies.
Supportive Intervention StrategiesSupportive intervention strategies encompass a wide range of tools. For example, therapeutic benefits of activity-based therapies includinganimal therapyor arts therapy and other tools like peer mentoring have been explored for supporting children who’ve experienced traumatic stress.
Supportive Intervention Strategies
Supportive intervention strategies encompass a wide range of tools. For example, therapeutic benefits of activity-based therapies includinganimal therapyor arts therapy and other tools like peer mentoring have been explored for supporting children who’ve experienced traumatic stress.
Therapy
How to Help Someone With Anosognosia
It is possible to help someone who doesn’t know they need help. While it can be tiring, frustrating, and even confusing, strategies include:
Types of Caregiver Burnout and How to Prevent It
Summary
Anosognosia is a symptom in which someone lacks insight or awareness about their medical condition. It can prevent someone from recognizing they need treatment, worsening recovery outcomes. The same factors contributing to a person’s underlying condition may contribute to someone experiencing anosognosia.
Symptoms and treatment vary depending on the cause. Healthcare professionals may prescribe medication or encourage psychotherapy and other supportive interventions for symptom relief. Understanding anosognosia is important to increasing treatment follow-through and improving recovery outcomes.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Alliance of Mental Illness.Anosognosia.Buckley PF, Wirshing DA, Bhushan P, Pierre JM, Resnick SA, Wirshing WC.Lack of insight in schizophrenia: Impact on treatment adherence.CNS Drugs.2007;21(2):129-41. doi: 10.2165/00023210-200721020-00004American Stroke Association.One-sided neglect.Alzheimer’s Society.Understanding denial and lack of insight.National Alliance on Mental Illness.The difficulty in seeing your own illness.Mograbi DC, Morris RG.Anosognosia.Cortex. 2018;103:385-386. doi:10.1016/j.cortex.2018.04.001Amador XF, Flaum M, Andreasen NC, Strauss DH, Yale SA, Clark SC, Gorman JM.Awareness of illness in schizophrenia and schizoaffective and mood disorders.Arch Gen Psychiatry. 1994;51(10):826-36. doi: 10.1001/archpsyc.1994.03950100074007National Alliance on Mental Illness.Anosognosia.Cambridge.Insight and psychosis.Stabell L, Johnsen E, Kroken R. Løberg LM, Blindheim A, Joa I, Reitan SK, Rettenbacher M, Munk-Jørgensen P, Gjestad E.Clinical insight among persons with schizophrenia spectrum disorders treated with amisulpride, aripiprazole or olanzapine: a semi-randomised trial.BMC Psychiatry.2023;23:482. doi:10.1186/s12888-023-04981-9Lysaker PH, Pattison ML, Leonhardt BL, Phelps S, Vohs JL.Insight in schizophrenia spectrum disorders: Relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.World Psychiatry.2018;17(1): 12–23. doi:10.1002/wps.20508National Institute on Alcohol Abuse and Alcoholism.Motivational enhancement therapy manual.Treatment Advocacy Center.Anosognosia.Macdonald G, Livingstone N, Hanratty J, McCartan C, Cotmore R, Cary M, Glaser D, Byford S, Welton NJ, Bosqui T, Bowes L, Audrey S, Mezey G, Fisher HL, Riches W, Churchill R.The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: An evidence synthesis.Types of interventions. NIHR Journals Library. 2016.Substance Abuse and Mental Health Services Administration.For friends and family members.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Alliance of Mental Illness.Anosognosia.Buckley PF, Wirshing DA, Bhushan P, Pierre JM, Resnick SA, Wirshing WC.Lack of insight in schizophrenia: Impact on treatment adherence.CNS Drugs.2007;21(2):129-41. doi: 10.2165/00023210-200721020-00004American Stroke Association.One-sided neglect.Alzheimer’s Society.Understanding denial and lack of insight.National Alliance on Mental Illness.The difficulty in seeing your own illness.Mograbi DC, Morris RG.Anosognosia.Cortex. 2018;103:385-386. doi:10.1016/j.cortex.2018.04.001Amador XF, Flaum M, Andreasen NC, Strauss DH, Yale SA, Clark SC, Gorman JM.Awareness of illness in schizophrenia and schizoaffective and mood disorders.Arch Gen Psychiatry. 1994;51(10):826-36. doi: 10.1001/archpsyc.1994.03950100074007National Alliance on Mental Illness.Anosognosia.Cambridge.Insight and psychosis.Stabell L, Johnsen E, Kroken R. Løberg LM, Blindheim A, Joa I, Reitan SK, Rettenbacher M, Munk-Jørgensen P, Gjestad E.Clinical insight among persons with schizophrenia spectrum disorders treated with amisulpride, aripiprazole or olanzapine: a semi-randomised trial.BMC Psychiatry.2023;23:482. doi:10.1186/s12888-023-04981-9Lysaker PH, Pattison ML, Leonhardt BL, Phelps S, Vohs JL.Insight in schizophrenia spectrum disorders: Relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.World Psychiatry.2018;17(1): 12–23. doi:10.1002/wps.20508National Institute on Alcohol Abuse and Alcoholism.Motivational enhancement therapy manual.Treatment Advocacy Center.Anosognosia.Macdonald G, Livingstone N, Hanratty J, McCartan C, Cotmore R, Cary M, Glaser D, Byford S, Welton NJ, Bosqui T, Bowes L, Audrey S, Mezey G, Fisher HL, Riches W, Churchill R.The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: An evidence synthesis.Types of interventions. NIHR Journals Library. 2016.Substance Abuse and Mental Health Services Administration.For friends and family members.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Alliance of Mental Illness.Anosognosia.Buckley PF, Wirshing DA, Bhushan P, Pierre JM, Resnick SA, Wirshing WC.Lack of insight in schizophrenia: Impact on treatment adherence.CNS Drugs.2007;21(2):129-41. doi: 10.2165/00023210-200721020-00004American Stroke Association.One-sided neglect.Alzheimer’s Society.Understanding denial and lack of insight.National Alliance on Mental Illness.The difficulty in seeing your own illness.Mograbi DC, Morris RG.Anosognosia.Cortex. 2018;103:385-386. doi:10.1016/j.cortex.2018.04.001Amador XF, Flaum M, Andreasen NC, Strauss DH, Yale SA, Clark SC, Gorman JM.Awareness of illness in schizophrenia and schizoaffective and mood disorders.Arch Gen Psychiatry. 1994;51(10):826-36. doi: 10.1001/archpsyc.1994.03950100074007National Alliance on Mental Illness.Anosognosia.Cambridge.Insight and psychosis.Stabell L, Johnsen E, Kroken R. Løberg LM, Blindheim A, Joa I, Reitan SK, Rettenbacher M, Munk-Jørgensen P, Gjestad E.Clinical insight among persons with schizophrenia spectrum disorders treated with amisulpride, aripiprazole or olanzapine: a semi-randomised trial.BMC Psychiatry.2023;23:482. doi:10.1186/s12888-023-04981-9Lysaker PH, Pattison ML, Leonhardt BL, Phelps S, Vohs JL.Insight in schizophrenia spectrum disorders: Relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.World Psychiatry.2018;17(1): 12–23. doi:10.1002/wps.20508National Institute on Alcohol Abuse and Alcoholism.Motivational enhancement therapy manual.Treatment Advocacy Center.Anosognosia.Macdonald G, Livingstone N, Hanratty J, McCartan C, Cotmore R, Cary M, Glaser D, Byford S, Welton NJ, Bosqui T, Bowes L, Audrey S, Mezey G, Fisher HL, Riches W, Churchill R.The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: An evidence synthesis.Types of interventions. NIHR Journals Library. 2016.Substance Abuse and Mental Health Services Administration.For friends and family members.
National Alliance of Mental Illness.Anosognosia.
Buckley PF, Wirshing DA, Bhushan P, Pierre JM, Resnick SA, Wirshing WC.Lack of insight in schizophrenia: Impact on treatment adherence.CNS Drugs.2007;21(2):129-41. doi: 10.2165/00023210-200721020-00004
American Stroke Association.One-sided neglect.
Alzheimer’s Society.Understanding denial and lack of insight.
National Alliance on Mental Illness.The difficulty in seeing your own illness.
Mograbi DC, Morris RG.Anosognosia.Cortex. 2018;103:385-386. doi:10.1016/j.cortex.2018.04.001
Amador XF, Flaum M, Andreasen NC, Strauss DH, Yale SA, Clark SC, Gorman JM.Awareness of illness in schizophrenia and schizoaffective and mood disorders.Arch Gen Psychiatry. 1994;51(10):826-36. doi: 10.1001/archpsyc.1994.03950100074007
National Alliance on Mental Illness.Anosognosia.
Cambridge.Insight and psychosis.
Stabell L, Johnsen E, Kroken R. Løberg LM, Blindheim A, Joa I, Reitan SK, Rettenbacher M, Munk-Jørgensen P, Gjestad E.Clinical insight among persons with schizophrenia spectrum disorders treated with amisulpride, aripiprazole or olanzapine: a semi-randomised trial.BMC Psychiatry.2023;23:482. doi:10.1186/s12888-023-04981-9
Lysaker PH, Pattison ML, Leonhardt BL, Phelps S, Vohs JL.Insight in schizophrenia spectrum disorders: Relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.World Psychiatry.2018;17(1): 12–23. doi:10.1002/wps.20508
National Institute on Alcohol Abuse and Alcoholism.Motivational enhancement therapy manual.
Treatment Advocacy Center.Anosognosia.
Macdonald G, Livingstone N, Hanratty J, McCartan C, Cotmore R, Cary M, Glaser D, Byford S, Welton NJ, Bosqui T, Bowes L, Audrey S, Mezey G, Fisher HL, Riches W, Churchill R.The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: An evidence synthesis.Types of interventions. NIHR Journals Library. 2016.
Substance Abuse and Mental Health Services Administration.For friends and family members.
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