Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T05:06:01.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Response and remission of subjective well-being in patients suffering from schizophrenia spectrum disorders

Published online by Cambridge University Press:  16 April 2020

R. Schennach-Wolff ,
F. Seemüller ,
M. Obermeier ,
T. Messer ,
G. Laux ,
H. Pfeiffer ,
D. Naber ,
L.G. Schmidt ,
W. Gaebel  and
J. Klosterkötter
...Show all authors
R. Schennach-Wolff*
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336Munich, Germany
F. Seemüller
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336Munich, Germany
M. Obermeier
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336Munich, Germany
T. Messer
Affiliation:
Psychiatric Clinic, District Hospital Augsburg, Augsburg, Germany
G. Laux
Affiliation:
Psychiatric Clinic, District Hospital Gabersee, Wasserburg/Inn, Germany
H. Pfeiffer
Affiliation:
Psychiatric Clinic, District Hospital Haar, Munich, Germany
D. Naber
Affiliation:
Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany
L.G. Schmidt
Affiliation:
Department of Psychiatry and Psychotherapy, University of Mainz, Mainz, Germany
W. Gaebel
Affiliation:
Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
J. Klosterkötter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
I. Heuser
Affiliation:
Department of Psychiatry and Psychotherapy, Charite Berlin, Campus Benjamin Franklin, Berlin, Germany
W. Maier
Affiliation:
Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
M.R. Lemke
Affiliation:
Department of Psychiatry and Psychotherapy, Alsterdorf Hospital, Hamburg, Germany
E. Rüther
Affiliation:
Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
G. Buchkremer
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
M. Gastpar
Affiliation:
Department of Psychiatry and Psychotherapy, University of Essen, Essen, Germany
M. Jäger
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336Munich, Germany
H.J. Möller
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336Munich, Germany
M. Riedel
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336Munich, Germany Psychiatric Clinic, Vinzenz-von-Paul-Hospital, Rottweil, Germany
*
*Corresponding author. Tel.: +49 89 5160 5511; fax: +49 89 5160 5728. E-mail address: [email protected] (R. Schennach-Wolff).
Get access

Abstract

Background

Purpose of this study was to assess subjective well-being in schizophrenia inpatients and to find variables predictive for response and remission of subjective well-being.

Method

The subjective well-being under neuroleptic treatment scale (SWN-K) was used in 232 schizophrenia patients within a naturalistic multicenter trial. Early response was defined as a SWN-K total score improvement of 20% and by at least 10 points within the first 2 treatment weeks, response as an improvement in SWN-K total score of at least 20% and by at least 10 points from admission to discharge and remission in subjective well-being as a total score of more or equal to 80 points at discharge. Logistic regression and CART analyses were used to determine valid predictors of subjective well-being outcome.

Results

Twenty-nine percent of the patients were detected to be SWN-K early responders, 40% fulfilled criteria for response in subjective well-being and 66% fulfilled criteria for remission concerning subjective well-being. Among the investigated predictors, SWN-K early improvement and the educational status were significantly associated with SWN-K response. The SWN-K total score at baseline showed a significant negative predictive value for response. Baseline SWN-K total score, PANSS global subscore, and side effects as well as the educational status were found to be significantly predictive for remission.

Conclusions

Depressive symptoms should be radically treated and side effects closely monitored to improve the patient's subjective well-being. The important influence of subjective well-being on overall treatment outcome could be underlined.

Keywords

Schizophrenia and psychosisQuality of lifeResponseRemissionPredictor variables
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 5 , August 2011 , pp. 284 - 292
Copyright
Copyright © Elsevier Masson SAS 2011

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

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth edition. Washington DC, American Psychiatric Association, 1994.Google Scholar
Andreasen, N.C., Carpenter, W.T. Jr., Kane, J.M., Lasser, R.A., Marder, S.R., Weinberger, D.R.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005; 162: 441–449CrossRefGoogle ScholarPubMed
Bobes, J., Garcia-Portilla, P., Saiz, P.A., Bascaran, T., Bousono, M.Quality of life measures in schizophrenia. Eur Psychiatry 2005; 20(Suppl. 3): S313–S317CrossRefGoogle Scholar
Caron, J., Lecomte, Y., Stip, E., Renaud, S.Predictors of quality of life in schizophrenia. Community Ment Health J 2005; 41: 399–417CrossRefGoogle Scholar
Carpiniello, B., Lai, G.L., Pariante, C.M., Carta, M.G., Rudas, N.Symptoms, standards of living and subjective quality of life: a comparative study of schizophrenic and depressed out-patients. Acta Psychiatr Scand 1997; 96: 235–241CrossRefGoogle ScholarPubMed
Cooke, M.A., Peters, E.R., Kuipers, E., Kumari, V.Disease, deficit or denial? Models of poor insight in psychosis. Acta Psychiatr Scand 2005; 112: 4–17CrossRefGoogle ScholarPubMed
Cording, C.Conceptual aspects in development and implementation of basic psychiatric documentation. Psychiatr Prax 1998; 25: 175–178Google ScholarPubMed
Corrigan, P.W., Buican, B.The construct validity of subjective quality of life for the severely mentally ill. J Nerv Ment Dis 1995; 183: 281–285CrossRefGoogle ScholarPubMed
Drake, R.E., Ehrlich, J.Suicide attempts associated with akathisia. Am J Psychiatry 1985; 142: 499–501Google ScholarPubMed
Emsley, R., Rabinowitz, J., Medori, R.Time course for antipsychotic treatment response in first-episode schizophrenia. Am J Psychiatry 2006; 163: 743–745CrossRefGoogle ScholarPubMed
Emsley, R., Rabinowitz, J., Medori, R.Remission in early psychosis: Rates, predictors, and clinical and functional outcome correlates. Schizophr Res 2007; 89: 129–139CrossRefGoogle ScholarPubMed
Fleischhacker, W.W.Pharmacological treatment of schizophrenia: a review;.. In: Maj, M.Sartorius, N.WPA Series Evidence and Experience in Psychiatry Chichester, England: John Wiley & Sons; 2002.75113Google Scholar
Franz, M., Meyer, T., Reber, T., Gallhofer, B.The importance of social comparisons for high levels of subjective quality of life in chronic schizophrenic patients. Qual Life Res 2000; 9: 481–489CrossRefGoogle ScholarPubMed
gtsson-Tops, A., Hansson, L.Subjective quality of life in schizophrenic patients living in the community relationship to clinical and social characteristics. Eur Psychiatry 1999; 14: 256–263CrossRefGoogle Scholar
gtsson-Tops, A., Hansson, L., Sandlund, M., Bjarnason, O., Korkeila, J., Merinder, L., et al.Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study. Qual Life Res 2005; 14: 221–229CrossRefGoogle Scholar
Hansson, L., Bjorkman, T.Are factors associated with subjective quality of life in people with severe mental illness consistent over time? A 6-year follow-up study. Qual Life Res 2007; 16: 9–16CrossRefGoogle ScholarPubMed
Hofer, A., Kemmler, G., Eder, U., Edlinger, M., Hummer, M., Fleischhacker, W.W.Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry 2004; 65: 932–939CrossRefGoogle ScholarPubMed
Jager, M., Riedel, M., Messer, T., Laux, G., Pfeiffer, H., Naber, D., et al.Psychopathological characteristics and treatment response of first episode compared with multiple episode schizophrenic disorders. Eur Arch Psychiatry Clin Neurosci 2007; 257: 47–53CrossRefGoogle ScholarPubMed
Kane, J.M., Fleischhacker, W.W., Hansen, L., Perlis, R., Pikalov, A. III, ssuncao-Talbott, S.Akathisia: an updated review focusing on second-generation antipsychotics. J Clin Psychiatry 2009; 70: 627–643CrossRefGoogle ScholarPubMed
Karow, A., Pajonk, F.G., Reimer, J., Hirdes, F., Osterwald, C., Naber, D., et al.The dilemma of insight into illness in schizophrenia: self- and expert-rated insight and quality of life. Eur Arch Psychiatry Clin Neurosci 2008; 258: 152–159CrossRefGoogle ScholarPubMed
Kay, S.R., Opler, L.A., Lindenmayer, J.P.Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry Res 1988; 23: 99–110CrossRefGoogle ScholarPubMed
Kinon, B.J., Chen, L., scher-Svanum, H., Stauffer, V.L., Kollack-Walker, S., Sniadecki, J.L., et al.Predicting response to atypical antipsychotics based on early response in the treatment of schizophrenia. Schizophr Res 2008; 102: 230–240CrossRefGoogle ScholarPubMed
Koivumaa-Honkanen, H., Honkanen, R., Viinamaki, H., Heikkila, K., Kaprio, J., Koskenvuo, M.Life satisfaction and suicide: a 20-year follow-up study. Am J Psychiatry 2001; 158: 433–439CrossRefGoogle ScholarPubMed
Lambert, M., Naber, D., Eich, F.X., Schacht, M., Linden, M., Schimmelmann, B.G.Remission of severely impaired subjective wellbeing in 727 patients with schizophrenia treated with amisulpride. Acta Psychiatr Scand 2007; 115: 106–113CrossRefGoogle ScholarPubMed
Lambert, M., Schimmelmann, B.G., Naber, D., Schacht, A., Karow, A., Wagner, T., et al.Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry 2006; 67: 1690–1697CrossRefGoogle ScholarPubMed
Lehman, A.F., Postrado, L.T., Rachuba, L.T.Convergent validation of quality of life assessments for persons with severe mental illnesses. Qual Life Res 1993; 2: 327–333CrossRefGoogle ScholarPubMed
Lingjaerde, O., Ahlfors, U.G., Bech, P., Dencker, S.J., Elgen, K.The UKU side effect rating scale. A new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand Suppl. 3341987[1-100:1-100]CrossRefGoogle Scholar
Mintz, AR, Addington, J, Addington, D. Insight in early psychosis: a 1-year follow-up. Schizophr Res 2004;67:213–7.CrossRefGoogle Scholar
Mueser, K.T., Douglas, M.S., Bellack, A.S., Morrison, R.L.Assessment of enduring deficit and negative symptom subtypes in schizophrenia. Schizophr Bull 1991; 17: 565–582CrossRefGoogle Scholar
Myrtek, M., Foerster, F.The law of initial value: a rare exception. Biol Psychol 1986; 22: 227–237CrossRefGoogle ScholarPubMed
Naber, D.A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol 1995; 10(Suppl. 3): 133–138Google ScholarPubMed
Pedrelli, P, McQuaid, JR, Granholm, E, Patterson, TL, McClure, F, Beck, AT, et al. Measuring cognitive insight in middle-aged and older patients with psychotic disorders. Schizophr Res 2004;71:297–305.CrossRefGoogle Scholar
Ponizovsky, A.M., Grinshpoon, A., Levav, I., Ritsner, M.S.Life satisfaction and suicidal attempts among persons with schizophrenia. Compr Psychiatry 2003; 44: 442–447CrossRefGoogle ScholarPubMed
Putzhammer, A., Perfahl, M., Pfeiff, L., Hajak, G.Correlation of subjective well-being in schizophrenic patients with gait parameters, expert-rated motor disturbances, and psychopathological status. Pharmacopsychiatry 2005; 38: 132–138CrossRefGoogle ScholarPubMed
R Development Core Team. A language and environment for statistical computing. URL http://w.R-project.org 2008 Vienna, Austria, Foundation for Statistical Computing. Ref Type: Computer Program.Google Scholar
Rettenbacher, M.A., Hofer, A., Eder, U., Hummer, M., Kemmler, G., Weiss, E.M., et al.Compliance in schizophrenia: psychopathology, side effects, and patients’ attitudes toward the illness and medication. J Clin Psychiatry 2004; 65: 1211–1218CrossRefGoogle ScholarPubMed
Ritsner, M.Predicting changes in domain-specific quality of life of schizophrenia patients. J Nerv Ment Dis 2003; 191: 287–294CrossRefGoogle ScholarPubMed
Ritsner, M., Gibel, A., Ratner, Y.Determinants of changes in perceived quality of life in the course of schizophrenia. Qual Life Res 2006; 15: 515–526CrossRefGoogle ScholarPubMed
Ritsner, M., Ponizovsky, A., Endicott, J., Nechamkin, Y., Rauchverger, B., Silver, H., et al.The impact of side-effects of antipsychotic agents on life satisfaction of schizophrenia patients: a naturalistic study. Eur Neuropsychopharmacol 2002; 12: 31–38CrossRefGoogle ScholarPubMed
Schwartz, R.C.Insight and illness in chronic schizophrenia. Compr Psychiatry 1998; 39: 249–254CrossRefGoogle ScholarPubMed
Sim, K, Mahendran, R, Siris, SG, Heckers, S, Chong, SA. Subjective quality of life in first episode schizophrenia spectrum disorders with comorbid depression. Psychiatry Res 2004;129:141–7.CrossRefGoogle Scholar
Skantze, K., Malm, U., Dencker, S.J., May, P.R., Corrigan, P.Comparison of quality of life with standard of living in schizophrenic out-patients. Br J Psychiatry 1992; 161: 797–801CrossRefGoogle ScholarPubMed
Sullivan, G., Wells, K.B., Leake, B.Clinical factors associated with better quality of life in a seriously mentally ill population. Hosp Community Psychiatry 1992; 43: 794–798Google Scholar
Vandiver, V.L.Quality of life, gender and schizophrenia: a cross-national survey in Canada, Cuba, and USA. Community Ment Health J 1998; 34: 501–511CrossRefGoogle Scholar
Voruganti, L.N., Heslegrave, R.J., Awad, A.G.Quality of life measurement during antipsychotic drug therapy of schizophrenia. J Psychiatry Neurosci 1997; 22: 267–274Google ScholarPubMed
Wehmeier, PM, Kluge, M, Schneider, E, Schacht, A, Wagner, T, Schreiber, W. Quality of life and subjective well-being during treatment with antipsychotics in out-patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2007;31:703–12.CrossRefGoogle Scholar
Weinstein, M.C., Fineberg, H.V.Clinical decisions analysis. Philadelphia, PA: WB Saunders: 1980Google Scholar
Wolwer, W., Buchkremer, G., Hafner, H., Klosterkotter, J., Maier, W., Moller, H.J., et al.German research network on schizophrenia-bridging the gap between research and care. Eur Arch Psychiatry Clin Neurosci 2003; 253: 321–329CrossRefGoogle ScholarPubMed
Young, A.S., Sullivan, G., Burnam, M.A., Brook, R.H.Measuring the quality of outpatient treatment for schizophrenia. Arch Gen Psychiatry 1998; 55: 611–617CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.