Compliance is a major issue in the treatment of schizophrenia. Many studies have attempted to identify factors that influence it.

To assess treatment adherence in patients with schizophrenia. To identify factors correlated with poor adherence.

It was a cross-sectional, descriptive and analytical study, involving 37 outpatients with DSM-IV diagnosis of schizophrenia, followed in the psychiatry department at the Hédi Chaker University Hospital of Sfax (Tunisia). The questionnaire included socio-demographic, clinical and therapeutic data. We also used the Medication Adherence Rating Scale “MARS”, the Insight Scale “IS” and the Stigma Scale (9 items).

The average age was 36.4 years. The majority of patients was male (68.8%), did not exceed the level of secondary education (89.2%) and had a low socioeconomic level (84.4%).

Paranoid schizophrenia was the most frequent type of schizophrenia (54.1%). Atypical antipsychotic were prescribed in 40.5% of cases.

Patients were non-adherent to treatment in 56.8% of cases. The factors correlated with poor adherence were: psychoactive substance use (P = 0.036), sexual dysfunction (P = 0.036), complexity of treatment (P = 0.036), poor insight according to the subscale “awareness of the need for treatment” of the IS (P = 0.047) and high score on the subscale “discrimination” of the Stigma Scale (P = 0.008).

Tunisian schizophrenic patients have a poor adherence to treatment. Acting on risk factors (such as substance use, sexual side effects, poor insight and discrimination perception) would improve patient compliance and management of schizophrenia.

The authors have not supplied their declaration of competing interest.