Several factors affect medication adherence in patients with schizophrenia; insight is among the most important ones.

The objective of our study was to assess insight in Tunisian patients with schizophrenia and to determine its impact on medication adherence.

We conducted a survey of all patients hospitalized in the department of psychiatry “C” in the Hedi Chaker University Hospital, in Sfax (Tunisia), during the period from January 2011 to April 2011, and in whom schizophrenia was diagnosed according to DSM IV-TR criteria.

We used the insight questionnaire Q8 and the 10-item version of the Drug Attitude Inventory (DAI) to assess insight and subjective response to antipsychotic treatment, respectively. The DAI is an indicator of future medication compliance.

Forty male patients were included. The mean age was 35 years. The average disease duration was 10.5 years. Paranoid schizophrenia was the most frequent type of schizophrenia (55%). The treatment perception was positive in half of our patients. Disorder awareness was good in only 30% of cases. We found a significant association between low level of insight and negative perception of treatment as measured by the DAI-10 (p = 0.038).

Tunisian schizophrenic patients had a low level of insight. Our results were consistent with data reported in the literature, namely that a low level of insight was associated with poor medication adherence; it would even be a predictive factor. This finding would be valid whatever the cultural context is.