To study attitude to disease in patients with the first episode of juvenile endogenous psychosis (ICD-10 items F20, F25, F30.21 and F32.3), authors examined 89 male patients. There were common patterns in attitude to disease caused by the pathoplastic effect of juvenile age and some differences that were correlated with premorbid personality features and the psychopathological structure of the psychotic episode. Normonosognosic, hyponosognosic, hypernosognosic and disnosognosic types of attitude to disease were singled out. Hyponosognosic type was the most common in patients with the first episode of juvenile endogenous psychosis. Its were elaborated recommendations for differential use of psychotherapeutic strategies which took into account attitude to disease and age of the patient.