Anosognosia is a condition in which a person with a disability is cognitively unaware of having it due to an underlying physical or psychological condition: e.g., PTSD, Stockholm syndrome, schizophrenia, bipolar disorder, dementia.

Anosognosia is a condition where a person with a certain disability or illness is not aware of or denies their condition.

It often occurs with individuals who have suffered some form of brain damage, such as a stroke or traumatic brain injury, and can lead to a lack of recognition or understanding of their own limitations.

Some individuals are completely unaware of their condition and others denying that they have any limitations despite clear evidence suggesting otherwise.

This condition is a result of the brain damage and not a deliberate choice by the individual.

The lack of insight into one’s disease.

It  can result from physiological damage to brain structures, typically to the parietal lobe or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere, and is thus a neuropsychiatric disorder. 

It is a deficit of self-awareness, and has similarities to denial, a psychological defense mechanism.

Anosognosia is sometimes accompanied by asomatognosia, a form of neglect in which patients deny ownership of body parts such as their limbs. 

Anosognosia can manifest by failure to be aware of a number of specific deficits, including motor, sensory, spatial, memory, and language due to impairment of anatomo-functionally discrete monitoring systems.

Anosognosia is relatively common following different causes of brain injury, such as stroke and traumatic brain injury.

Anosognosia for hemiparesis with onset of acute stroke is estimated at between 10% and 18%.

Anosognosia can appear to occur in conjunction with virtually any neurological impairment. 

Anosognosia is more frequent in the acute than in the chronic phase.

Anosognosia is  more prominent for assessment in the cases with right hemispheric lesions than with the left.

Anosognosia does not seem to be directly related to sensory loss but is thought to be caused by damage to higher level neurocognitive processes that are involved in integrating sensory information with processes that support spatial or bodily representations.

Anosognosia is thought to be related to unilateral neglect, after damage to the non-dominant, usually the right hemisphere of the cerebral cortex in which people seem unable to attend to, or sometimes comprehend, anything on a certain side of their body usually the left.

It can be selective process  in that an affected person with multiple impairments may seem unaware of only one handicap, while appearing to be fully aware of any others.

Stroke patients with mild and severe levels of anosognosia as determined by response to an anosognosia questionnaire, have been linked to lesions within the temporoparietal and thalamic regions, when compared to those who experience moderate anosognosia, or none at all.

In contrast, after a stroke, people with moderate anosognosia have a higher frequency of lesions involving the basal ganglia, compared to those with mild or severe anosognosia.

In regard to anosognosia for neurological patients, no long-term treatments exist. 

Caloric reflex testing can temporarily ameliorate unawareness of impairment. 

Most cases of anosognosia appear to simply disappear over time.

Some cases of  anosognosia last  indefinitely. 

Normally, long-term cases are treated with cognitive therapy to train patients to adjust for their inoperable limbs, or use feedback — comparing clients’ self-predicted performance with their actual performance on a task in an attempt to improve insight.

Anosognosia impairs the patient’s desire to seek medical aid, it may also impair their ability to seek rehabilitation, as a lack of awareness of the deficit makes cooperative, mindful work with a therapist difficult. 

Individuals with severe mental illnesses that lack awareness of illness is significantly associated with both medication non-compliance and re-hospitalization.

Fifteen percent of individuals with severe mental illness refuse to take medication voluntarily because of anosognosia, and may require coercive psychiatric treatment.

Anosognosia is also closely related to other cognitive dysfunctions that impair the capacity to participate in treatment.

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