Correlation of Subjective Well-being in Schizophrenic Patients with Gait Parameters, Expert-rated Motor Disturbances, and Psychopathological Status

Abstract

Subjective well-being of schizophrenic patients can be impaired by symptoms of the disease and by adverse effects of antipsychotic medication. We assessed the correlations of subjective well-being with objectively measured gait parameters, expert-rated motor disturbances, and psychopathological status in 25 conventionally treated, 25 atypically treated, and 16 drug-naive patients. Main variables were the SWN scores (Subjective Well-being under Neuroleptic Treatment Scale), the ESRS scores (Extrapyramidal Symptoms Rating Scale), and the PANSS scores (Positive and Negative Syndrome Scale). Gait parameters were determined by using an ultrasonic system for gait analysis. In conventionally treated patients, the SWN total score significantly correlated with stride length ( R(2) = 0.39; P < 0.01), whereas in atypically treated and drug-naive patients, it significantly correlated with the PANSS score (atypically treated: R(2) = 0.25, P < 0.05; drug-naive: R(2) = 0.64, P < 0.01), mainly due to the correlations with the "negative symptoms" and the "general psychopathology" sub-scores. Correlations with stride length were significant not only in the "physical functioning" sub-score of the SWN but also in all other sub-scores. Correlations of the SWN scores with ESRS scores were weak. Under conventional antipsychotic treatment, subjective well-being particularly depends on major side effects, whereas in atypically treated and drug-naive schizophrenic patients, it is mainly influenced by psychopathological status. Motor adverse effects of conventional antipsychotic treatment cannot be considered as isolated physical side effects but have severe implications for other aspects of the patients' well-being.