Schizophrenia is a serious disorder that influences all life aspects of the patients. The most important goals in schizophrenia are remission, recovery, improving psychosocial functioning and quality of life, which can be influenced by different factors, especially insight.

To evaluate the awareness of illness in Romanian patients diagnosed with schizophrenia and to determine the predictive role of insight.

This study wants to highlight the importance of the evaluation of insight in psychotic patients, taking into account that awareness leads to compliance with treatment, decreased rate of relapses and rehospitalization and a better prognosis.

Overall, 80 patients (44 males and 36 females) recruited from first and second psychiatric clinic Cluj-Napoca, diagnosed according to ICD-10 and DSM-V criteria with schizophrenia and acute psychotic disorder participated in this study. A semi-structured interview collected demographical data. Psychotic symptoms were evaluated using PANSS, severity of the disease using CGI and insight using SUMD.

Our results showed that the most important predictive factors for the evolution were: level of insight (r = −0.41 P < 0.01), presence of family history (r = 0.24 P < 0.05) and belonging to urban areas (r = 0.23 P < 0.05). The level of insight explained 16% of variance of improving psychotic symptoms during hospitalization.

The awareness of illness is one of the predictive factors for long-term schizophrenia and the best predictive model of disease progression is composed of variables SUMD total and PANSS total on admission.

The authors have not supplied their declaration of competing interest.