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Eur Neuropsychopharmacol. 2014 Jul;24(7):1078-85. doi: 10.1016/j.euroneuro.2014.03.001. Epub 2014 Mar 15.

Effect of antipsychotic medication on overall life satisfaction among individuals with chronic schizophrenia: findings from the NIMH CATIE study.

Author information

1
Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8; Institute of Medical Science, University of Toronto, Toronto, Canada. Electronic address: gagan.fervaha@utoronto.ca.
2
Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
3
Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8; Department of Psychiatry, University of Toronto, Toronto, Canada.

Abstract

The field of schizophrenia is redefining optimal outcome, moving beyond clinical remission to a more comprehensive model including functional recovery and improved subjective well-being. Although numerous studies have evaluated subjective outcomes within the domain of subjective quality of life in patients with schizophrenia, less is known about global evaluations of subjective well-being. This study examined the effects of antipsychotic medication on overall life satisfaction in patients with chronic schizophrenia. Data were drawn from the Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) study, where participants with a DSM-IV diagnosis of schizophrenia were randomized to receive olanzapine, perphenazine, quetiapine, risperidone or ziprasidone under double-blind conditions (N=753). The primary outcome measure was prospective change in subjectively evaluated overall life satisfaction scores following 12 months of antipsychotic treatment. Psychopathology, medication side effects and functional status were also evaluated, among other variables. Patients experienced modest improvements in overall life satisfaction (d=0.22, p<0.001), with no differences between antipsychotic medications (all tests, p>0.05). Change in severity of positive, negative, and depressive symptoms as well as functional status each demonstrated a small, albeit statistically significant, association with change in life satisfaction (r=0.10-0.21, p׳s<0.01). In a multivariate regression model, change in clinical symptoms and functional status had limited independent predictive value for change in life satisfaction scores (explained variance <3%). These data suggest that despite antipsychotic medications being effective for symptom-based psychopathology, such clinical effectiveness does not necessarily translate to improved general satisfaction with life. Clinicians should be aware that these two domains are not inextricably linked.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00014001.

KEYWORDS:

Antipsychotic treatment; Life satisfaction; Outcome; Quality of life; Schizophrenia; Well-being

PMID:
24726579
DOI:
10.1016/j.euroneuro.2014.03.001
[Indexed for MEDLINE]
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