Abstract
BackgroundNon-adherence to medication remains a major challenge in the long-term management of patients with schizophrenia. Next to lack of insight into the illness, adverse effects of antipsychotic drugs, cognitive deficits, poor therapeutic alliance, reduced quality of life, missing social support, and negative attitudes toward medication are predictors of non-adherence. This study examined potential correlations between attitudes toward antipsychotic drug therapy, subjective well-being, and symptom change in patients with chronic schizophrenia.Methods30 patients with schizophrenia starting monotherapy with a new-generation antipsychotic were included into the study. The Drug Attitude Inventory (DAI) and the Subjective Well-being under Neuroleptic Treatment Scale, short form (SWN-K), were administered after 2, 4, and 12 weeks of treatment. At the same points in time and at baseline, psychopathological symptoms were rated by means of the Positive and Negative Syndrome Scale (PANSS), and functioning was assessed by means of the Global Assessment of Functioning Scale (GAF). Antipsychotic induced side effects were evaluated by using the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale.ResultsStudy participants had a mean age of 37.5 ± 9.7 years, baseline symptoms were mild. The PANSS total score improved significantly from baseline to weeks 4 (p = .003) and 12 (p = .001), respectively. Neither the DAI total score nor the SWN-K total score changed significantly over the course of time. The severity of symptoms was not correlated with drug attitude at any time point but was negatively correlated with wellbeing at weeks 2 (r = −.419, p = .021) and 4 (r = −.441, p = .015). There was no significant correlation between DAI and SWN-K total scores at any time point.ConclusionsNext to showing that the DAI and the SWN-K measure different aspects of subjective experiences during antipsychotic treatment these findings emphasize the use of both instruments to optimize adherence to medication.
Highlights
Non-adherence to medication remains a major challenge in the long-term management of patients with schizophrenia
Naber et al developed the “Subjective Well-being under Neuroleptic Treatment” scale (SWN), which captures the subjective experiences of patients during antipsychotic drug treatment [12, 20] and has inconsistently been shown to correlate with current symptomatology or changes in psychopathology [20,21,22]
Associations of Subjective Well-being under Neuroleptic Treatment Scale (SWN)-K and Drug Attitude Inventory (DAI) scores with patient characteristics, symptomatology (PANSS), side effects (UKU) and Global Assessment of Functioning Scale (GAF) were investigated by means of the Spearman rank correlation coefficient, as part of the variables involved were non-normally distributed
Summary
Non-adherence to medication remains a major challenge in the long-term management of patients with schizophrenia. This study examined potential correlations between attitudes toward antipsychotic drug therapy, subjective well-being, and symptom change in patients with chronic schizophrenia. Several scales have been developed to assess quality of life in patients with schizophrenia [7] and both the impact of pharmacological therapy on quality of life and the relationship between subjective experience and attitudes and adherence to medication attracted attention over the past decades. Naber et al developed the “Subjective Well-being under Neuroleptic Treatment” scale (SWN), which captures the subjective experiences of patients during antipsychotic drug treatment [12, 20] and has inconsistently been shown to correlate with current symptomatology or changes in psychopathology [20,21,22]
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