Insight is defined as the recognition that one has a mental disorder, the ability to identify its symptoms, and cognizance of the need for treatment. Lack of insight into having a mental disorder is found to be associated with a poorer clinical outcome, treatment noncompliance, and a more severe cognitive impairment.

Compare the insight and medication adherence in a population of schizophrenia and bipolar disorder patients.

We assessed and compared the insight and compliance of 60 patients with schizophrenia (n=30) and bipolar disorder (n=30) recruited in Psychiatry department Sfax, Tunisia.

Insight was assessed using the rating scale of consciousness disorder (Q8).

Adherence was assessed using the Drug Attitude Inventory [ICD-10].

Patients were mainly young adults, male (70%) and did not live in a couple (61.7%).

About half of them (43.3%) had no profession.

Insight was low in 15% of patients, intermediate in 53.3%, and good in 31.7% of cases. Bipolar disorder patients displayed better insight into having a mental disorder compared to schizophrenia patients (p=0.04)

Good adherence was observed in 64.4% of patients.

Factor influencing adherence in both populations was the type of treatment: patients treated with atypical antipsychotics have better compliance (p = 0.005).

A good insight was significantly correlated with good adherence (p = 0.000)

Our results showed that bipolar disorder patients have better insight compared to schizophrenia patients. So it is necessary; in schizophrenia; to work on awareness of the disorder and the need for treatment to improve adherence.