Effects and side effects of antipsychotic treatment in schizophrenia: Pros and cons of available self-rating scales

Abstract

Introduction To support clinical practice as well as clinical research, self-rating scales have been developed to evaluate the effects and side effects of antipsychotic treatment. The aim of this study is to compare the psychometric properties and other characteristics of frequently used self-rating scales, and also to study their relationship to subjective quality of life. Method Four self-rating scales designed to evaluate the treatment effects of antipsychotics were identified through a MEDLINE and cross-references search: The Drug Attitude Inventory (DAI-10), The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), Subjective Well-being to Neuroleptics (SWN) and the recently developed Subjects' Reaction to Antipsychotics questionnaire (SRA). Three hundred and twenty patients with schizophrenia who were treated with antipsychotics completed these questionnaires, including a quality of life instrument, the WHO-QoLBREF. Results The self-rating scales differed in scope, number of items and subscales (total and subscale scores), but showed an acceptable internal reliability (Cronbach's alphas varying between .64 and .93) except for the DAI-10 (.52), and all were easy to complete (in less than 20 min). They did not strongly correlate with each other, except for the LUNSERS and SRA undesired experiences subscale ( r = .68, p < .01). All correlations with quality of life were statistically significant, but were especially so for the SWN (.78, p < .01). Conclusion Clinicians interested in the experience of the effects and side effects of antipsychotic medication in their patients are well advised to carefully consider the pros and cons of the available rating scales. They differ with respect to their internal reliability, concurrent and conceptual validity, as well as with respect to desired and undesired effects, aspects of quality of life, and attribution to medication. The choice also depends on its intended use, whether in clinical practice or in research or in both.