Introduction: Subjective well-being of schizophrenic patients can be impaired by symptoms of the disease and by adverse effects of antipsychotic medication. We assessed the correlations of subjective well-being with objectively measured gait parameters, expert-rated motor disturbances, and psychopathological status in 25 conventionally treated, 25 atypically treated, and 16 drug-naive patients. Methods: Main variables were the SWN scores (Subjective Well-being under Neuroleptic Treatment Scale), the ESRS scores (Extrapyramidal Symptoms Rating Scale), and the PANSS scores (Positive and Negative Syndrome Scale). Gait parameters were determined by using an ultrasonic system for gait analysis. Results: In conventionally treated patients, the SWN total score significantly correlated with stride length (R2 = 0.39; P < 0.01), whereas in atypically treated and drug-naive patients, it significantly correlated with the PANSS score (atypically treated: R2 = 0.25, P < 0.05; drug-naive: R2 = 0.64, P < 0.01), mainly due to the correlations with the ”negative symptoms” and the ”general psychopathology” sub-scores. Correlations with stride length were significant not only in the ”physical functioning” sub-score of the SWN but also in all other sub-scores. Correlations of the SWN scores with ESRS scores were weak. Conclusion: Under conventional antipsychotic treatment, subjective well-being particularly depends on major side effects, whereas in atypically treated and drug-naive schizophrenic patients, it is mainly influenced by psychopathological status. Motor adverse effects of conventional antipsychotic treatment cannot be considered as isolated physical side effects but have severe implications for other aspects of the patients’ well-being.
References
1
Allan E R, Sison C E, Alpert M, Connolly B, Crichton J.
The relationship between negative symptoms of schizophrenia and extrapyramidal side effects with haloperidol and olanzapine.
Psychopharmacol Bull.
1998;
34
71-74
2
Allison D B, Mackell J A, McDonnell D D.
The impact of weight gain on quality of life among persons with schizophrenia.
Psychiatr Serv.
2003;
54
565-567
3
Awad A G, Voruganti L N, Heslegrave R J, Hogan T P.
Assessment of the patient’s subjective experience in acute neuroleptic treatment: implications for compliance and outcome.
Int Clin Psychopharmacol.
1996;
11 Suppl 2
55-59
4
Browne S, Garavan J, Gervin M, Roe M, Larkin C, O’Callaghan E.
Quality of life in schizophrenia: insight and subjective response to neuroleptics.
J Nerv Ment Dis.
1998;
186
74-78
5
Browne S, Roe M, Lane A, Gervin M, Morris M, Kinsella A, Larkin C, Callaghan E O.
Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology and tardive dyskinesia.
Acta Psychiatr Scand.
1996;
94
118-124
8
de Haan L, Lavalaye J, Linszen D, Dingemans P M, Booij J.
Subjective experience and striatal dopamine D(2) receptor occupancy in patients with schizophrenia stabilized by olanzapine or risperidone.
Am J Psychiatry.
2000;
157
1019-1020
9
de Haan L, Lavalaye J, van Bruggen M, van Nimwegen L, Booij J, van Amelsvoort T, Linszen D.
Subjective experience and dopamine D2 receptor occupancy in patients treated with antipsychotics: clinical implications.
Can J Psychiatry.
2004;
49
290-296
10
de Haan L, van Bruggen M, Lavalaye J, Booij J, Dingemans P M, Linszen D.
Subjective experience and D2 receptor occupancy in patients with recent-onset schizophrenia treated with low-dose olanzapine or haloperidol: a randomized, double-blind study.
Am J Psychiatry.
2003;
160
303-309
11
de Haan L, Weisfelt M, Dingemans P M, Linszen D H, Wouters L.
Psychometric properties of the Subjective Well-Being Under Neuroleptics scale and the Subjective Deficit Syndrome Scale.
Psychopharmacology (Berl).
2002;
162
24-28
12
Fenton W S, Blyler C R, Heinssen R K.
Determinants of medication compliance in schizophrenia: empirical and clinical findings.
Schizophr Bull.
1997;
23
637-651
13
Garavan J, Browne S, Gervin M, Lane A, Larkin C, O’Callaghan E.
Compliance with neuroleptic medication in outpatients with schizophrenia; relationship to subjective response to neuroleptics; attitudes to medication and insight.
Compr Psychiatry.
1998;
39
215-219
15
Gervin M, Browne S, Garavan J, Roe M, Larkin C, O’Callaghan E.
Dysphoric subjective response to neuroleptics in schizophrenia: relationship to extrapyramidal side effects and symptomatology.
Eur Psychiatry.
1999;
14
405-409
17
Jaeger J, Bitter I, Czobor P, Volavka J.
The measurement of subjective experience in schizophrenia: the Subjective Deficit Syndrome Scale.
Compr Psychiatry.
1990;
31
216-226
19
Lacro J P, Dunn L B, Dolder C R, Leckband S G, Jeste D V.
Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature.
J Clin Psychiatry.
2002;
63
892-909
20
Lambert M, Schimmelmann B G, Karow A, Naber D.
Subjective well-being and initial dysphoric reaction under antipsychotic crugs - concepts, measurement and clinical relevance.
Pharmacopsychiatry.
2003;
36 Suppl 3
S181-190
21
Larsen E B, Gerlach J.
Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics.
Acta Psychiatr Acand.
1996;
93
381-388
23
Lindstrom L H.
Long-term clinical and social outcome studies in schizophrenia in relation to the cognitive and emotional side effects of antipsychotic drugs.
Acta Psychiatr Scand Suppl.
1994;
380
74-6, 74 - 76
24
Loffler W, Kilian R, Toumi M, Angermeyer M C.
Schizophrenic patients’ subjective reasons for compliance and noncompliance with neuroleptic treatment.
Pharmacopsychiatry.
2003;
36
105-112
26
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
133-8
29 Naber D, Karow A, Lambert M. Subjective well-being under neuroleptic treatment and its relevance for compliance. Acta Psychiatr Scand Suppl 2004: in print
30
Naber D, Moritz S, Lambert M, Pajonk F G, Holzbach R, Mass R, Andresen B, Rajonk F.
Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs.
Schizophr Res.
2001;
50
79-88
31
Prosser E S, Csernansky J G, Kaplan J, Thiemann S, Becker T J, Hollister L E.
Depression, parkinsonian symptoms, and negative symptoms in schizophrenics treated with neuroleptics.
J Nerv Ment Dis.
1987;
175
100-105
32
Putzhammer A, Heindl B, Broll K, Pfeiff L, Perfahl M, Hajak G.
Spatial and temporal parameters of gait disturbances in schizophrenic patients.
Schizophr Res.
2004;
69
159-166
34
Ramaekers J G, Louwerens J W, Muntjewerff N D, Milius H, de Bie A, Rosenzweig P, Patat A, O’Hanlon J F.
Psychomotor, Cognitive, extrapyramidal, and affective functions of healthy volunteers during treatment with an atypical (amisulpride) and a classic (haloperidol) antipsychotic.
J Clin Psychopharmacol.
1999;
19
209-221
35
Rettenbacher M A, Burns T, Kemmler G, Fleischhacker W W.
Schizophrenia: attitudes of patients and professional carers towards the illness and antipsychotic medication.
Pharmacopsychiatry.
2004;
37
103-109
36
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
31-38
38
Spohn H E, Coyne L.
The effect of attention/information processing impairment of tardive dyskinesia and neuroleptics in chronic schizophrenics.
Brain Cogn.
1993;
23
28-39
