Medication adherence problems increase hospitalization, morbidity and mortality in the patients with the diagnosis of schizophrenia. Indicators of poor adherence to a medication regimen are a useful resource for physicians to help identify patients who are most in need of interventions to improve adherence.

The objective of this analysis was to find out whether symptoms and insight would predict the therapeutic alliance in the treatment of schizophrenia.

We proceeded to a transverse survey with 95 patients affected by schizophrenia followed in ambulatory in the psychiatric department D of the hospital Razi in Tunisia.

A little more than half our patients were not observing. The behavior of observance was positively correlated in the sex: the men were more observant that the women. The clinical shape of the disease, the level of insight, the cognitive state as well as the age of the disease are not connected to the degree of compliance. On the other hand, the positive or negative psychotic symptoms are strongly correlated in the therapist alliance.

The results of this study suggest that simple measures as the psychoeducation for schizophrenics, and control of the psychotic symptoms advance us on the way of improvement of the therapist alliance and consequently the social reintegration of the patient and his quality of life.