Negative future self as a mediator in the relationship between insight and depression in psychotic disorders

Awareness of illness in psychotic disorders is associated with better clinical outcomes, but also poorer psychological well-being. This is known as “The Insight Paradox”. Understanding of the paradox has focused on the role of self-stigma. This study examines possible future self as a mediator in the relationship between insight and depression in 102 individuals in an early intervention program for psychosis. Mediation analysis demonstrated that negative possible self was the sole significant independent mediator in a model which included self-stigma. Our study shows that awareness of mental illness and perception that it will negatively impact future self increases likelihood of depression.