Self- and caregiver-perceived disability, subjective well-being, quality of life and psychopathology improvement in long-acting antipsychotic treatments: a 2-year follow-up study

Int J Psychiatry Clin Pract. 2021 Sep;25(3):307-315. doi: 10.1080/13651501.2021.1912358. Epub 2021 May 31.

Abstract

Objective: Switching to long-acting injectable (LAI) antipsychotic maintenance treatment (AMT) represents a valuable strategy for schizophrenia. In a recovery-oriented approach, patient-reported outcomes (PROs) such as perceived disability, subjective well-being, and quality of life cannot be neglected.

Methods: Forty clinically stable outpatients with schizophrenia treated with oral second-generation antipsychotics were enrolled at the time of switching to the equivalent dose of LAI. 35 subjects completed this 2-year longitudinal, prospective, open-label, observational study. Patients were assessed at baseline, after 1 year, and after 2 years of LAI-AMT, using psychometric scales (Positive And Negative Syndrome Scale, PANSS; Young Mania Rating Scale, YMRS; Montgomery-Åsberg Depression Rating Scale, MADRS), PROs (Subjective Well-Being under Neuroleptics short form, SWN-K; Short Form-36 health survey, SF-36; 12-item World Health Organisation Disability Assessment Schedule, WHODAS 2.0), and caregiver-reported outcomes (12-item WHODAS 2.0).

Results: No psychotic relapses were observed. Psychopathology measures (PANSS total and subscales - excluding negative symptoms), mood symptoms (YMRS, MADRS), perceived disability (patient- and caregiver-administered WHODAS 2.0), subjective well-being (SWN-K), and quality of life (SF-36) showed a concomitant amelioration after 1 year, without further significant variations.

Discussion: Switching to LAI-AMT may decrease perceived impairment, and increase subjective well-being and quality of life in clinically stable outpatients with schizophrenia.HighlightsLAI treatment may improve outcomes by reducing psychopathology levels and relapses.In a recovery-oriented approach, patient-reported outcomes cannot be neglected.LAI antipsychotics may optimise the subjective experience of treatment.Switching to LAI therapy may result in a reduction in perceived disability.There is a significant correlation between proxy- and patient-reported disability.

Keywords: LAI; Schizophrenia; disability; patient-reported outcomes; quality of life; subjective experience.

Publication types

  • Observational Study

MeSH terms

  • Antipsychotic Agents / therapeutic use
  • Caregivers* / psychology
  • Diagnostic Self Evaluation*
  • Disabled Persons / psychology
  • Follow-Up Studies
  • Humans
  • Prospective Studies
  • Quality of Life
  • Recurrence
  • Schizophrenia* / drug therapy
  • Schizophrenic Psychology*
  • Treatment Outcome

Substances

  • Antipsychotic Agents