# The insight paradox among inpatients diagnosed with schizophrenia in Japan: a comparison of self-esteem across groups classified by insight and internalized stigma - URL: https://alisanburak.com/en/wcp-2026-posterler/ev1068 - Language: en - Last updated: not specified - Page title: The insight paradox among inpatients diagnosed with schizophrenia in Japan: a comparison of self-esteem across groups classified by insight and internalized stigma | WCP 2026 Summary > Four clusters were identified based on insight and internalized stigma in a Japanese inpatient sample. Self-esteem was lowest in the Paradox group, and a previ… This page was translated automatically from Turkish. [Read the original](https://alisanburak.com/wcp-2026-posterler/ev1068) This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it. EV1068 E-PosterStigma and RecoveryCross-sectional study # The insight paradox among inpatients diagnosed with schizophrenia in Japan: a comparison of self-esteem across groups classified by insight and internalized stigma THE INSIGHT PARADOX IN INPATIENTS WITH SCHIZOPHRENIA IN JAPAN: A COMPARISON OF SELF-ESTEEM AMONG GROUPS CLASSIFIED BY INSIGHT AND INTERNALIZED STIGMA Presenter: Riho Mitsubayashi Country: Japan Institution: University of Tsukuba, Graduate School of Comprehensive Human Sciences Four clusters were identified based on insight and internalized stigma in a Japanese inpatient sample. Self-esteem was lowest in the Paradox group, and a previously unidentified Denial group emerged. The aim of the study was to classify inpatients diagnosed with schizophrenia in Japan according to insight and internalized stigma and to compare self-esteem across the resulting clusters. In an exploratory cross-sectional study conducted at four psychiatric hospitals, 125 inpatients aged 18 years and older were recruited, and 83 were included in the analysis; the mean age was reported as 58.5 years (standard deviation 14.6). The measures used were the SAI-J for insight, the BE-PSD-J for psychiatric symptoms, the ISMI-10 for internalized stigma, and the Rosenberg Self-Esteem Scale for self-esteem; non-hierarchical k-means cluster analysis and the Kruskal–Wallis test with Bonferroni correction were applied. Four clusters were identified: Acceptance (n = 14), Paradox (n = 23), Unaware (n = 18), and a new Denial group (n = 28) that had not been identified in previous Western studies. Median self-esteem scores were 32.0 in the Acceptance group, 20.0 in the Paradox group, 29.5 in the Unaware group, and 26.0 in the Denial group, with a significant difference across groups (χ² = 29.141, p < 0.001); age (χ² = 16.259, p = 0.001), length of hospital stay (χ² = 26.608, p < 0.001), and BE-PSD-J scores (χ² = 34.962, p < 0.001) also differed across groups. The authors note that Japan's high rates of involuntary admission and prolonged hospitalization facilitated the inclusion of individuals with low treatment engagement, who are underrepresented in Western studies, and that this may explain the emergence of the new Denial group. As a clinical implication, they emphasize that insight should be understood more broadly as part of a person's sense of self, rather than solely as acceptance of a diagnosis, and that efforts to support insight should also consider subjective outcomes such as internalized stigma and self-esteem. [View the original poster](https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1525) How to cite this study APA 7: Mitsubayashi, R., et al. (2026, September 23-26). The insight paradox in inpatients with schizophrenia in japan: a comparison of self-esteem among groups classified by insight and internalized stigma [E-poster]. 26th WPA World Congress of Psychiatry (WCP 2026), Stockholm, Sweden. https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1525 Vancouver: Mitsubayashi R, et al. The insight paradox in inpatients with schizophrenia in japan: a comparison of self-esteem among groups classified by insight and internalized stigma [e-poster]. 26th WPA World Congress of Psychiatry (WCP 2026); 2026 Sep 23-26; Stockholm, Sweden. 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