Inadequate insight into mental illness is a strong
predictor of nonadherence,44 and this is a potential
mechanism through which it may increase the risk of
violence in schizophrenia. However, in a forensic sample
of individuals with psychotic disorders, poor insight into
illness and nonadherence to medications had
independent associations with severity of violence.45
Medication adverse effects such as parkinsonism, weight
gain, and loss of libido are well known to reduce
adherence.