Quality of life and subjective well-being during treatment with antipsychotics in out-patients with schizophrenia

Abstract

Objective To assess the Quality of Life (QOL) in outpatients with schizophrenia under antipsychotics from two perspectives: a “subjective” perspective as rated by the patient and an “objective” perspective as rated by the physician. Method EASE (External Assessment of Quality of Life in Out-patients with Schizophrenia) is a 12-month, prospective, naturalistic study of the QOL in patients on antipsychotic treatment for schizophrenia in an out-patient setting in Germany. The study included 1462 patients who were initiated on a new antipsychotic or switched to another antipsychotic. The Subjective Well-being under Neuroleptics scale (SWN) and the Quality of Life Scale (QLS) were used to assess the QOL in these patients. The Clinical Global Impression (CGI) scale was used to assess overall symptom severity. Four cohorts were identified and evaluated: (a) patients treated with olanzapine monotherapy ( N = 1007), (b) another atypical antipsychotic as monotherapy ( N = 335), (c) a typical antipsychotic as monotherapy ( N = 32) and (d) combination therapy with more than one antipsychotic ( N = 88). Results QOL as assessed by both SWN and QLS improved in all treatment cohorts. SWN responses in the respective cohorts were (a) 52.3%, (b) 38.8%, (c) 31.3% and (d) 44.3%, whilst the QLS responses were (a) 58.2%, (b) 45.1%, (c) 59.4% and (c) 40.9%. Symptom severity as assessed by the CGI also improved over time regardless of the type of antipsychotic. An increase of one point on the CGI corresponded to a change in SWN total score of − 9.67 points and a change in QLS total score of − 13.36 points. Conclusions Both QOL and symptom severity improved over the 12-month study period, regardless of the type of antipsychotic taken. QOL improvement as perceived both from a “subjective” and an “objective” perspective was greatest in the cohort on olanzapine monotherapy.