Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-08T15:32:56.414Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence

Published online by Cambridge University Press:  16 April 2020

M. Lambert ,
P. Conus ,
P. Eide ,
R. Mass ,
A. Karow ,
S. Moritz ,
D. Golks  and
D. Naber
M. Lambert*
Affiliation:
Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University of Hamburg, Martini street 52, 20246Hamburg, Germany
P. Conus
Affiliation:
Département Universitaire de Psychiatrie Adulte, Clinique de Cery, 1008Prilly, Switzerland
P. Eide
Affiliation:
Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
R. Mass
Affiliation:
Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University of Hamburg, Martini street 52, 20246Hamburg, Germany
A. Karow
Affiliation:
Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University of Hamburg, Martini street 52, 20246Hamburg, Germany
S. Moritz
Affiliation:
Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University of Hamburg, Martini street 52, 20246Hamburg, Germany
D. Golks
Affiliation:
Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University of Hamburg, Martini street 52, 20246Hamburg, Germany
D. Naber
Affiliation:
Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University of Hamburg, Martini street 52, 20246Hamburg, Germany
*
*Corresponding author. Email addresses:[email protected]
Get access

Abstract

Objective

(1) determine which antipsychotic side effects (SE) schizophrenic patients consider the most distressing during treatment with typical antipsychotics, (2) measure the impact of actual and past SE on patients' attitude toward antipsychotics and (3) assess the influence of both on adherence.

Methods

The 213 schizophrenics, treated with conventional antipsychotics, were recruited in two psychiatric hospitals in Hamburg. Subjects were assessed about type and severity of present and past side effects and their attitude and adherence to antipsychotic treatment.

Results

The 82 (39%) patients presented present SE while 131 (61%) did not. Sexual dysfunctions (P<0.001), extrapyramidal (P<0.05) and psychic side effects (P<0.05) were rated as significantly subjectively more distressing than sedation or vegetative side effects. Patients presenting with present SE compared with patients without present SE had a significantly more negative general attitude toward antipsychotics (P<0.05), were more doubtful about their efficacy (P<0.01) and were less likely to encourage a relative to take such a medication in case of need (P<0.001). A regression analysis indicated that nonadherence was mainly influenced by negative general and efficacy attitudes toward antipsychotics and the experience of past or present antipsychotic side effects.

Conclusions

All antipsychotic side effects, present or past, can have a durable negative impact on patient's attitude toward antipsychotic treatment and adherence. Non-adherence is mainly determined, among other factors, by these negative attitudes, which are partly influenced by the experience of past or present antipsychotic-induced side effects.

Keywords

SchizophreniaTypical antipsychoticsSide effectsAttitudeAdherence
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 7 , November 2004 , pp. 415 - 422
Copyright
Copyright © European Psychiatric Association 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Affleck, JW, Burns, J, Forrest, AD. Long-term follow-up of schizo phrenic patients in Edinburgh. Acta Psychiatr Scand 1976;53(3):227– 37.Google Scholar
Allison, DB, Mackell, JA, McDonnell, DD. The impact of weight gain on quality of life among persons with schizophrenia. Psychiatr Serv 2003;54(4):565–7.CrossRefGoogle ScholarPubMed
Amador, XF, Strauss, DH, Yale, SA, Flaum, MM, Endicott, J, Gorman, JM. Assessment of insight in psychosis. Am J Psychiatry 1993; 150(6):873–9.Google ScholarPubMed
Angermeyer, MC, Matschinger, H. Antipsychotics and quality of life. A patient survey. Psychiatry Prax 2000;27(2):64–8.Google ScholarPubMed
Awad, AG, Voruganti, LN, Heslegrave, RJ, Hogan, TP. Assessment of the patient’s subjective experience in acute antipsychotic treatment: implications for compliance and outcome. Int Clin Psychopharmacol 1996;11(Suppl 2):55–9.Google ScholarPubMed
Berardi, D, Giannelli, A, Barnes, TR. Clinical correlates of akathisia in acute psychiatric inpatients. Int Clin Psychopharmacol 2000;15(4): 215–9.CrossRefGoogle ScholarPubMed
Buchanan, A. A two-year prospective study of treatment compliance in patients with schizophrenia. Psychol Med 1992;22(3):787–97.CrossRefGoogle ScholarPubMed
Cabeza, IG, Amador, MS, Lopez, CA, Gonzalez de Chavez, M. Subjective response to antipsychotics in schizophrenic patients: clinical implications and related factors. Schizophr Res 2000;41(2):349–55.CrossRefGoogle ScholarPubMed
Collins, EJ, Hogan, TP, Desai, H. Measurement of therapeutic response in schizophrenia: a critical survey. Schizophr Res 1991;51:249–53.CrossRefGoogle Scholar
Corrigan, PW, Liberman, RP, Engel, JD. From noncompliance to collaboration in the treatment of schizophrenia. Hosp Community Psychiatry 1990;41(11):1203–11.Google ScholarPubMed
Cuffel, BJ, Alford, J, Fischer, EP, Owen, RR. Awareness of illness in schizophrenia and outpatient treatment adherence. J Nerv Ment Dis 1996;184(11):653–9.CrossRefGoogle ScholarPubMed
David, A, Buchanan, A, Reed, A, Almeida, O. The assessment of insight in psychosis. Br J Psychiatry 1992;161:599–602.CrossRefGoogle ScholarPubMed
Davis, JM, Kane, JM, Marder, SR, Brauzer, B, Gierl, B, Schooler, N, Casey, DE, Hassan, M. Dose response of prophylactic antipsychotics. J Clin Psychiatry 1993;54(Suppl):24–30.Google ScholarPubMed
De Haan, L, Peters, B, Dingemans, P, Wouters, L, Linszen, D. Attitudes of patients toward the first psychotic episode and the start of treatment. Schizophr Bull 2002;28(3):431–42.CrossRefGoogle ScholarPubMed
Dixon, L, Weiden, P, Torres, M, et al. Assertive community treatment and medication compliance in the homeless mentally ill. Am J Psychiatry 1997;154:1302–4.Google ScholarPubMed
Donohoe, G, Owens, N, O’Donnell, C, Burke, T, Moore, L, Tobin, A, O’Callaghan, E. Predictors of compliance with antipsychotic medication among inpatients with schizophrenia: a discriminant function analysis. Eur Psychiatry 2001;16(5):293–8.CrossRefGoogle ScholarPubMed
Fenton, WS, Blyler, CR, Heinssen, RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997;23(4):637–51.CrossRefGoogle ScholarPubMed
Fleischhacker, WW, Oehl, MA, Hummer, M. Factors influencing compliance in schizophrenia patients. J Clin Psychiatry 2003;64(Suppl 16):10–3.Google ScholarPubMed
Gervin, M, Browne, J, Garavan, M, Roe, C, Larkin, C, Callaghan, O. Dysphoric subjective response to antipsychotics in schizophrenia: relationship to extrapyramidal side-effects and symptomatology. Eur Psychiatry 1999;14:405–9.CrossRefGoogle ScholarPubMed
Hellewell, JSE. Kalali, AH, Langham, SJ, et al. Patient satisfaction and acceptability of long-term treatment with quetiapine. Int J Psychiatry Clin Prac 1999;3:105–13.CrossRefGoogle ScholarPubMed
Hellewell, JS. Patients’ subjective experiences of antipsychotics: clinical relevance. CNS Drugs 2002;16(7):457–71.CrossRefGoogle ScholarPubMed
Hofer, A, Kemmler, G, Eder, U, Honeder, M, Hummer, M, Fleischhacker, WW. Attitudes toward antipsychotics among outpatient clinic attendees with schizophrenia. J Clin Psychiatry 2002;63(1):49–53.CrossRefGoogle ScholarPubMed
Holzinger, A, Loffler, W, Muller, P, Priebe, S, Angermeyer, MC. Subjective illness theory and antipsychotic medication compliance by patients with schizophrenia. J Nerv Ment Dis 2002;190(9):597–603.CrossRefGoogle ScholarPubMed
Jarema, M, Murawiec, S, Szafranski, T, Szaniawska, A, Konieczynska, Z. Subjective and objective evaluation of treating schizophrenia with classic or atypical drugs. Psychiatr Pol 2001;35(1):5–19.Google ScholarPubMed
Jeste, SD, Patterson, TL, Palmer, BW, Dolder, CR, Goldman, S, Jeste, DV. Cognitive predictors of medication adherence among middle-aged and older outpatients with schizophrenia. Schizophr Res 2003;63(1–2):49–58.CrossRefGoogle ScholarPubMed
Kampman, O, Lehtinen, K, Lassila, V, Leinonen, E, Poutanen, O, Koivisto, A. Attitudes towards neuroleptic treatment: reliability and validity of the attitudes towards neuroleptic treatment (ANT) questionnaire. Schizophr Res 2000;45(3):223–34.CrossRefGoogle ScholarPubMed
Kampman, O, Laippala, P, Vaananen, J, Koivisto, E, Kiviniemi, P, Kilkku, N, Lehtinen, K. Indicators of medication compliance in first-episode psychosis. Psychiatry Res 2002;110(1):39–48.CrossRefGoogle ScholarPubMed
Kemp, R, David, A. Psychological predictors of insight and compliance in psychotic patients. Br J Psychiatry 1996;169(4):444–50.CrossRefGoogle ScholarPubMed
Kemp, R, Hayward, P, Applewhaite, G, Everitt, B, David, A. Compliance therapy in psychotic patients: randomised controlled trial. BMJ 1996; 10(7027):345–9 312.CrossRefGoogle Scholar
Lacro, JP, Dunn, LB, Dolder, CR, Leckband, SG, Jeste, DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002;63(10):892–909.CrossRefGoogle ScholarPubMed
Larsen, EB, Gerlach, J. Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot antipsychotics. Acta Psychiatr Scand 1996;93(5):381–8.CrossRefGoogle Scholar
Lingjaerde, O, Ahlfors, UG, Bech, P, Dencker, SJ, Elgen, K. The UKU side effect rating scale. A new comprehensive rating scale for psycho-tropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand 1987;334(Suppl):1–00.CrossRefGoogle Scholar
Loffler, W, Kilian, R, Toumi, M, Angermeyer, MC. Schizophrenic patients’ subjective reasons for compliance and noncompliance with neuroleptic treatment. Pharmacopsychiatry 2003;36(3):105–12.Google ScholarPubMed
Naber, D, Moritz, S, Lambert, M, Pajonk, FG, Holzbach, R, Mass, R, Andresen, B, Rajonk, F. Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophr Res 2001;50(1-2):79–88.CrossRefGoogle ScholarPubMed
Overall, JE, Gorham, DR. The brief psychiatric rating scale. Psychological Reports 1986;10:799.Google Scholar
Ritsner, M, Ponizovsky, A, Endicott, J, Nechamkin, Y, Rauchverger, B, Silver, H, Modai, I. The impact of side-effects of antipsychotic agents on life satisfaction of schizophrenia patients: a naturalistic study. Eur Neuropsychopharmacol 2002;12(1):31–8.CrossRefGoogle ScholarPubMed
Sajatovic, M, Rosch, DS, Sivec, HJ, Sultana, D, Smith, DA, Alamir, S, Buckley, P, Bingham, CR. Insight into illness and attitudes toward medications among inpatients with schizophrenia. Psychiatr Serv 2002;53(10):1319–21.CrossRefGoogle ScholarPubMed
Smith, CM, Barzman, D, Pristach, CA. Effect of patient and family insight on compliance of schizophrenic patients. J Clin Pharmacol 1997;37(2):147–54.CrossRefGoogle ScholarPubMed
Van Putten, T. Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry 1974;31:67–72.CrossRefGoogle ScholarPubMed
Van Putten, T, Crumpton, E, Yale, C. Drug refusal in schizophrenia and wish to be crazy. Arch Gen Psychiatry 1976;33:1443–6.CrossRefGoogle ScholarPubMed
Voruganti, L, Cortese, L, Oyewumi, L, Cernovsky, Z, Zirul, S, Awad, A. Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, side-effect profile and impact on quality of life. Schizophr Res 2000;43(2–3):135–45.CrossRefGoogle ScholarPubMed
WHO SCAN-Schedules for clinical assessment in neuropsychiatry Genf: World Health Organization, Division of Mental Health; 1992.Google Scholar
Woods, SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 2003;64:663–7.CrossRefGoogle ScholarPubMed
Zygmunt, A, Olfson, M, Boyer, CA, Mechanic, D. Interventions to improve medication adherence in schizophrenia. Am J Psychiatry 2002;159(10):1653–64.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.