Objective To investigate the effects of empathy on the insight of first-episode schizophrenia.Methods Empathy with tbe interpersonal reactivity index-C (IRI-C) was applied to 71 patients with first-episode schizophrenia and 69 healthy controls.In addition,schizophrenic patients were evaluated with scale of unawareness of mental disorder (SUMD) for the scores of clinical insight and positive and negative syndrome scale (PANSS) for clinical symptoms.Results Compared with the control group,the schizophrenic patients showed lower scores in the perspective taking ((13.85±1.86) vs (6.74±2.56),P＜0.01),empathic concern ((14.28±2.16) vs (17.49± 2.73),P＜0.01) of IRI-C,but higher subscale score ((10.28±2.78) vs (8.93±1.93),P＜0.01) in personal distress.Pearson correlation analysis showed that,there were negatively significant correlations between insight score and perspective taking (r=-0.429,P＜0.01),empathic concern (r=-0.709,P＜0.01) subscores of IRI-C respectively.In addition,the insight total score was positively correlated with the positive symptoms subscores (r=0.545,P＜0.01) of PANSS.Conclusion Patients with first-episode schizophrenia have significant empathy defects.And the empathic deficits are associated with the insight impairment among the schizophrenic patients,suggesting that patients' insight level can change by improving their empathy ability.