scholarly journals Subjective effects of antipsychotic drugs and their relevance for compliance and remission

2008 ◽  
Vol 17 (3) ◽  
pp. 174-176 ◽  
Author(s):  
Dieter Naber
Keyword(s):  
Negative Symptoms ◽  
Subjective Effects ◽  
Well Being ◽  
Important Change ◽  
Self Report ◽  
Subjective Well Being ◽  
Early Improvement ◽  
Patient’S Perspective ◽  
Schizophrenic Patients ◽  
Major Predictor

AbstractOnly recently, success criteria became more ambitious and include a more thorough consideration of negative symptoms and cognitive dysfunction. The most important change within the last decade is the long overdue consideration of the patient's perspective. His/her subjective well-being, often unchanged or even worsened by typical antipsychotics, was neglected for a long time. One reason was the prejudice that schizophrenic patients are not able to self-rate their quality of life. Another reason was the belief that such data are not necessary because the psychiatrists' perspective, “objective” psychopathology, includes these domains. Among other scales, a self-report instrument has been constructed to evaluate “subjective well-being under neuroleptics” (SWN). This scale was used in numerous open and controlled trials, indicating: a) patients, if no longer acutely psychotic or suffering from severe cognitive deficits, are able to reliably assess their subjective well-being, b) high SWN is correlated with high compliance, c) atypical antipsychotics increase SWN, and d) individual improvements of SWN and of PANSS are not strongly related. Moreover, several studies found that early improvement of subjective well-being is a major predictor for the chance of remission. All these data indicate that a better consideration of the patient's perspective is possible and necessary.

scholarly journals Subjective well-being Under Neuroleptic Treatment. Relevance for Compliance and Remission

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Naber
Keyword(s):  
Dopamine D2 Receptor ◽  
Well Being ◽  
Self Report ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
List Type ◽  
Subjective Response ◽  
Subjective Well Being ◽  
Subjective Improvement ◽  
Early Improvement

Within the last decade, success criteria of antipsychotic treatment became more ambitious. The most important change is the long overdue consideration of the patient"s perspective. Among other scales, a self-report instrument has been constructed to evaluate “subjective well-being under neuroleptics” (SWN). Studies indicate:a.schizophrenic patients, if no longer acutely psychotic or suffering from severe cognitive deficits, are able to reliably assess their SWN,b.high SWN is correlated with high compliance,c.atypical antipsychotics increase SWN,d.individual improvements of SWN and of PANSS are not strongly related (r=-.30 - -.40), and e) dopamine D2 receptor blockade is highly correlated to reduced SWN (r = .66 - .76).Several open trials reveal the relevance of early improvement of subjective well-being: In a 12-week trial with 727 patients, 95% of those with early subjective response (within 4 weeks) showed later subjective and/or psychopathological improvement, but only 9% without early subjective response showed later improvement. In another 3-year trial of 2690 patients, again psychopathological response as well as symptomatic and functional remission were mostly related to early (within first 3 months) subjective improvement. Finally, in a first-episode study of 110 patients with a follow-up of 5 years, within the first 6 weeks of antipsychotic treatment only improvement of SWN was related to enduring symptomatic remission (p=.004) while early reduction of PANSS did not predict long-term course. These data indicate the usefulness of self-rating in schizophrenia, insufficient subjective improvement needs to be identified early.

scholarly journals The impact of subjective well-being under neuroleptic treatment on compliance and remission

2006 ◽  
Vol 8 (1) ◽  
pp. 131-136 ◽  
Keyword(s):  
Rating Scale ◽  
Well Being ◽  
Self Report ◽  
Systematic Evaluation ◽  
Antipsychotic Treatment ◽  
Strong Impact ◽  
Subjective Well Being ◽  
Schizophrenic Patients ◽  
Long Term Prognosis ◽  
The Impact

The patients' perspective of antipsychotic treatment was largely neglected for a long period. It has only been during the last 10 years, with the development of atypical antipsychotics, that scientific interest in this issue has markedly increased. Numerous studies have shown that the majority of schizophrenic patients are able to fill out a self-rating scale in a meaningful way, and several self-report scales with sufficient internal consistency and good construct validity have been developed. The effects of antipsychotic treatment on psychopathology and on subjective well-being (SW) are not strongly related; the perspectives of the patient and his/her psychiatrist markedly differ. Recent research indicates that SW/quality of life, much more improved by atypical than by typical antipsychotics, has a strong impact on compliance, as well as on the chance of achieving remission. The data strongly suggest that a systematic evaluation of the patient's perspective of antipsychotic treatment is meaningful and necessary to increase compliance, functional outcome, and long-term prognosis.

Quality: A non-interventional study evaluating quality of life in schizophrenic patients treated with atypical antipsychotics in the ambulatory setting

2011 ◽  
Vol 26 (S2) ◽  
pp. 1474-1474
Author(s):  
J. Peuskens ◽  
E. Fontaine ◽  
T. Vanlerberghe
Keyword(s):  
Quality Of Life ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Short Form ◽  
Well Being ◽  
Ambulatory Setting ◽  
Subjective Well Being ◽  
Symptom Scale ◽  
Schizophrenic Patients

ObjectivesThe QUALITY study evaluated Quality-of-Life in schizophrenic patients treated with atypical antipsychotics (AAPs) in the ambulatory setting.MethodsThis study was a 9-month, observational, multicentre prospective study. Patients (18–65 years-old) diagnosed with schizophrenia and treatment started with one AAP before visit-1 (minimum: 4-weeks, maximum: 8-weeks) were enrolled into this Belgian study. At visit-1 patients’ demographics and medical history were recorded with follow-up visits after 3-, 6- and 9-months. At each visit, patients completed the Subjective Well-being under Neuroleptic treatment short form (SWN-K), while investigators assessed the Positive and Negative Symptom Scale (PANSS-8) and Global Assessment of Functioning.Results121 patients were enrolled: 91 male, mean age 36.7 ± 10.8years. The main AAPs were risperidone (38/121), apripirazole (28/121) and quetiapine (25/121). On average, most mean changes from baseline in SWN-K-subscale scores were positive (between −0.5 and +0.5, range −1.8–1.6) suggesting patients felt better, although there were no treatment-group differences. The associations between baseline SWN-K-subscales and age were small (RC [regression co-efficient] range: −0.03–0.01). PANSS-8-score changes were slightly negative (means between −0.77 and −0.43) suggesting decreased symptom severity. Patients with more severe negative symptoms considered their mental- and physical-functioning to be better throughout the study, indicated by significant correlations between these SWN-K-subscale scores and negative PANSS-scores (RC = 0.19, p = 0.0282; RC = 0.15, p = 0.0258). The associations between SWN-K-scores and positive PANSS-scores were small (RC: 0.01–0.14). The number of hospitalizations decreased during the study (9.6% between visit-1 and 2 vs. 7.5% visit-3 and −4).ConclusionsQuality-of-life for all patients seemed to improve slightly, without any differences between treatment-groups.

scholarly journals Associations between symptom severity and well-being among Thai patients with schizophrenia: a cross-sectional analytical study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teerapat Teetharatkul ◽  
Arnont Vitayanont ◽  
Tippawan Liabsuetrakul ◽  
Warut Aunjitsakul
Keyword(s):  
Logistic Regression ◽  
Symptom Severity ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Well Being ◽  
Self Report ◽  
Subjective Well Being ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Middle Income

Abstract Background Severity of symptoms in patients with schizophrenia is a determinant of patient’s well-being, but evidence in low- and middle-income countries is limited. We aimed to measure the symptom severity using objective measurements, the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity scale (CGI-S), and their associations with well-being in patients with schizophrenia. Methods Patients with schizophrenia aged ≥18 years, without active psychosis including no history of hospitalization within the last 6 months, were included. Symptom severity was measured by the clinicians using BPRS and CGI-S. The patients’ well-being was assessed by self-report using the Subjective Well-being under Neuroleptic treatment scale (SWN) as continuous and binary outcomes (categorized into adequate or poor well-being). Correlations between symptom severity (BPRS and CGI-S scores) and well-being (SWN score) were analyzed using Pearson’s correlation. Association between well-being status and BPRS was analyzed using multivariate logistic regression. Results Of 150 patients, BPRS and CGI-S were inversely correlated with SWN score (r = − 0.47; p < 0.001 and − 0.21; p < 0.01, respectively). BPRS Affect domain had the highest correlation with SWN (r = − 0.51, p < 0.001). In multivariate logistic regression, BPRS score and being unemployed were associated with poor well-being status (adjusted OR 1.08; 95%CI 1.02–1.14; p = 0.006, and 4.01; 95%CI 1.38–11.7; p = 0.011, respectively). Conclusion Inverse relationships between symptom severity and well-being score were found. Higher BPRS Affect domain was significantly associated with lower patients’ well-being. The use of BPRS tool into routine clinical practice could serve as an adjunct to physician’s clinical evaluation of patients’ symptoms and may help improve patient’s well-being. Further research on negative symptoms associated with well-being is required.

Patient reported measures and functional remission

2011 ◽  
Vol 26 (S2) ◽  
pp. 2074-2074
Author(s):  
D. Naber
Keyword(s):  
Atypical Antipsychotics ◽  
Subjective Experience ◽  
Well Being ◽  
Self Report ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Subjective Response ◽  
Subjective Well Being ◽  
Early Improvement ◽  
Patient Reported

Only recently success criteria became more ambitious and include a more thorough consideration of the patient's perspective. Recent data indicate that in addition to the positive influence of a good relationship between doctor and patient, the subjective experience of antipsychotic treatment is a major predictor of compliance.Among other scales, a self-report instrument has been constructed to evaluate “subjective well-being under neuroleptics” (SWN). Data indicate: a) schizophrenic patients, if no longer acutely psychotic or suffering from severe cognitive deficits, are able to reliably assess their subjective well-being, b) high SWN is correlated with high compliance, c) atypical antipsychotics increase SWN, d) individual improvements of SWN and of PANSS are not strongly related (r = -.30 - -.40), and e) dopamine D2 receptor blockade is highly correlated to reduced SWN (r = .66–.76).Recent trials reveal the relevance of early improvement of subjective well-being: In a 12-week trial 95% of those with early subjective response (within 4 weeks) showed later subjective and/or psychopathological improvement, but only 9% without early subjective response showed later improvement. In another 3-year trial again psychopathological response as well as symptomatic and functional remission were not only related to young age and treatment with atypical antipsychotics, but mostly to early (within the first 3 months) subjective improvement. Moreover in a five year trial of first episode patients, marked improvement of SWN within the first 6 weeks of antipsychotic treatment was found to be related to enduring remission, while early improvement of PANSS did not predict outcome.

scholarly journals Adolescents’ Bipolar Experiences and Suicide Risk: Well-Being and Mental Health Difficulties as Mediators

2021 ◽  
Vol 18 (6) ◽  
pp. 3024
Author(s):  
Ascensión Fumero ◽  
Rosario J. Marrero ◽  
Alicia Pérez-Albéniz ◽  
Eduardo Fonseca-Pedrero
Keyword(s):  
Behavioral Problems ◽  
Suicide Risk ◽  
Well Being ◽  
Self Report ◽  
Emotional Difficulties ◽  
Subjective Well Being ◽  
Mediation Analyses ◽  
Mental Health Difficulties ◽  
The Mean ◽  
Age Range

Bipolar disorder is usually accompanied by a high suicide risk. The main aim was to identify the risk and protective factors involved in suicide risk in adolescents with bipolar experiences. Of a total of 1506 adolescents, 467 (31%) were included in the group reporting bipolar experiences or symptoms, 214 males (45.8%) and 253 (54.2%) females. The mean age was 16.22 (SD = 1.36), with the age range between 14 and 19. Suicide risk, behavioral and emotional difficulties, prosocial capacities, well-being, and bipolar experiences were assessed through self-report. Mediation analyses, taking gender as a moderator and controlling age as a covariate, were applied to estimate suicide risk. The results indicated that the effect of bipolar experiences on suicide risk is mediated by behavioral and emotional difficulties rather than by prosocial behavior and subjective well-being. Specifically, emotional problems, problems with peers, behavior problems, and difficulties associated with hyperactivity were the most important variables. This relationship was not modulated by gender. However, the indirect effects of some mediators varied according to gender. These results support the development of suicide risk prevention strategies focused on reducing emotional difficulties, behavioral problems, and difficulties in relationships with others.

Patterns of Social Relationships and Psychological Well-being among the Elderly

1997 ◽  
Vol 21 (3) ◽  
pp. 417-430 ◽  
Author(s):  
Keiko Takahashi ◽  
Junko Tamura ◽  
Makiko Tokoro
Keyword(s):  
Human Resources ◽  
Social Relationships ◽  
Well Being ◽  
The Elderly ◽  
Self Esteem ◽  
Subjective Health ◽  
Self Report ◽  
Subjective Well Being ◽  
Psychological Well Being ◽  
Type Method

On the premise that social relationships among elderly adults differ in terms of the most significant, dominant figure, this study aimed to examine: (1) whether there were qualitative differences in supportive functions between family-dominant and friend-dominant affective relationships, and (2) whether “lone wolves”, who were deficient in human resources, had difficulties in maintaining their well-being. A total of 148 Japanese, over the age of 65, both living in communities and in institutions were individually interviewed about their social relationships using a self-report type method, the Picture Affective Relationships test, and their well-being was assessed using Depression, Self-esteem, Life satisfaction, and Subjective health scales. Results showed that there were no differences in psychological well-being between family-dominant and friend-dominant participants, but those who lacked affective figures had lower scores in subjective well-being than did their family-dominant and friend-dominant counterparts. The generalisation of these findings to other cultures is discussed.

The Functional Recovery Scale in Schizophrenia (FRSS): Relationship to panss

2011 ◽  
Vol 26 (S2) ◽  
pp. 2073-2073
Author(s):  
P.-M. Llorca ◽  
L. Samalin ◽  
O. Blanc ◽  
Keyword(s):  
Social Functioning ◽  
Functional Recovery ◽  
Educational Level ◽  
Latent Variable ◽  
Negative Symptoms ◽  
Treatment Strategies ◽  
Well Being ◽  
Subjective Well Being ◽  
Cross Sectional ◽  
Quality Of Life Scale

Schizophrenia is a severe and disabling disorder, which affects multiple functional domains adversely.Several factors like premorbid functioning and psychopathological symptoms can affect functional outcome. Residual psychopathology after an acute exacerbation has a variable influence, going from a weak correlation to positive symptoms to clear association of negative symptoms with reduced social functioning to widespread influence of cognitive symptoms.We performed a cross-sectional evaluation in a sample of 296 schizophrenic patients for demographic, functional characteristics (using different scales: Functional Recovery Scale in Schizophrenia (FRSS), Subjective Well-being Scale (SWN-K), Quality of Life Scale (QLS)) and symptomatic (using the Positive and Negative Syndrome Scale (PANSS)). Exploratory multivariate analyses were conducted and a model with “functioning” as a latent variable was proposed and tested. Results: Using the 5 clinical dimensions of the PANSS, negative, cognitive and excitation factors are significant predictors of functioning. The model was constructed with “functioning” defined as a latent variable; indicators are sub-scores on FRSS, SWN-K, QLS and exogenous variables included symptomatology, Duration of Untreated Psychosis and educational level. The negative and cognitive dimensions are highly correlated via the latent variable to the 3 dimensions of functioning evaluated by the FRSS: “daily life”, “social functioning” and “treatment” and the QLS sub-scores (“interpersonal”, “common object”, “instrumental role”). Educational level is significantly linked to functioning but not DUP. The model emphasizes the need for treatment strategies that have an effect on negative and cognitive factors, to improve functioning in schizophrenia.

scholarly journals Screening Using the SDQ Total Difficulties Scale: An Analog Test of Three Cutoff Values

2019 ◽  
Author(s):  
Tyler L Renshaw
Keyword(s):  
Well Being ◽  
The Self ◽  
Self Report ◽  
Future Research ◽  
Subjective Well Being ◽  
Analog Test ◽  
Research And Practice ◽  
Cutoff Values ◽  
Dependent Variables ◽  
Strengths And Difficulties

This brief report presents an analog test of the relative classification validity of three cutoff values (CVs; 16, 18, and 20) derived from responses to the self-report version of the Strengths and Difficulties Questionnaire: Total Difficulties Scale. Results from Bayesian t-tests, using several school-specific subjective well-being indicators as dependent variables, yielded evidence suggesting all CV models effectively differentiated between students with lower and higher levels of risk. Evidence also indicated that the lowest CV (16) was more effective than the higher CVs (18, 20) at identifying students with greater levels of risk, and that the higher CVs functioned comparably well. Implications for future research and practice are noted.

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