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Heroin Addiction and Related Clinical Problems: 2022, 24, N2 (pages: 45 - 51)

Exploring impaired insight in opioid addiction: the role of self-stigma

Eidenmueller K., Grimm F., Hermann D., Frischknecht U., Kiefer F., Dziobek I., and Bekier N.K.

Summary: Background. Impaired insight into illness has been demonstrated in patients with different substance dependences, including patients in opioid maintenance treatment (OMT), and has been shown to be of relevance for treatment motivation and outcomes. While influences on insight have been studied in other psychiatric disorders, there is a lack of research into influences on insight in addiction. Our study aimed at exploring the influence of substance use related variables, executive functions (EF), theory of mind (ToM) and self-stigma in OMT patients. Methods. 59 OMT patients‘ insight into illness was assessed using a modified version of the Hanil Alcohol Insight Scale (HAIS). Furthermore, patients completed a short EF test battery, a theory of mind test (MASC) and a modified version of the Internalized Stigma of Mental Illness Inventory (ISMI). Results. 28.8% of participants had poor insight, 69.5% had fair insight and 1,7% of participants had good insight according to the HAIS. Insight did not significantly correlate with EF, ToM or any substance use related variables. However, we found a negative correlation between self-stigma and intellectual insight in the HAIS. Stigma resistance on the other hand correlated positively with the HAIS total score and intellectual insight. Conclusions. Our results suggest that the dominant mechanisms influencing insight in opioid dependence may differ from those in psychotic disorders. The relationship between insight and self-stigma and its implications for clinical practice and further research are discussed.