QUALITY OF LIFE OF PATIENT WITH SCHIZOPHRENIA TREATED BY CONVENTIONAL AND ATYPICAL NEUROLEPTICS
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Abstract
Background: the quality of life of patients suffering from schizophrenia was extensively studied but it seems that impact on quality of life of neuroleptics, particularly atypical antipsychotic treatment was not clearly elucidated.
Aims: In this study we have compared the impact on quality of life of atypical antipsychotic versus classic neuroleptics.
Methods: We have enrolled, prospectively, all patients with schizophrenia as confirmed by DSM – IV TR. These patients intakes antipsychotics for unless 6 months. We excluded patients with acute schizophrenia, mental deficiency and severe organic disease. Evaluation of clinical features is based on the PANSS scale (Positive And Negative Syndrome Scale). The quality of life is evaluated using the MOS-SF36 scale (Medical Outcomes Study 36-item Short Form). Extra pyramidal symptoms were evaluated by the Chouinard scale
Results: We have enrolled 65 patients; 35 under classic neuroleptics and 30 under atypical antipsychotics. Clinical features were similar in the two groups. Patients with atypical antipsychotics were less hospitalized (2,4±3,2 vs 4,5±4,2 ; p=0,02) and needing less anti cholinergic treatment (26,6 % vs 88,6 %; p <0,0001). Adverse effects were more common with classic neuroleptics (Pakinsonism score : 6,1± 7 vs10,8±8,6 ; P =0,01); global clinical dyskinesia 1,22±0,8 vs 1,90±1,7; p=0,04; global clinical judgement of parkinsonism (2,4±2,1 vs 3,72±2,4; p=0,02). Quality of life was better in patients with atypical antipsychotics on
the basis of vitality (76,7±27,8 vs 62±29,6; p=0,04) and social function (53,3±33 vs 36,9±27,5; p=0,03) we found a negative correlation between adverse effects and quality of life in patients with classic neuroleptics
Conclusion: Quality of life of patients suffering from schizophrenia with atypical antipsychotics is better than in those with classic neuroleptics and this may be due to the frequency of adverse effects particularly extra pyramidal symptoms.
Keywords:
Neuroleptics, Quality of life, Schizophrenia, social adaptation##plugins.themes.academic_pro.article.details##
References
- Awed AG. A conceptual model of quality of life in schizophrenia. Qual Life Res 1997; 6: 21-6
- AwadAG, Vorganti LNP. Quality of life and new antipsychotics in schizophrenia are patients better off?. International Journal of Social Psychiatry 1999; 45: 268-75.
- AwadAG, Vorganti LNP. New Antipsychotics, Compliance, Quality of life, and Subjective. Tolerability- Are patients better off?. Can J Psychiatry 2004; 49:297-301
- Bond GR, Meyer PS. The role of medications in the employment of people with schizophrenia. Journal of Rehabilitation 1999; 65 : 9 16.
- Bradshaw W, Brekke JS. Subjective experience in schizophrenia: Factors influencing self-esteem, satisfaction with life, and subjective distress. Am J Orthopsychiatry 1999; 69:254-60.
- Caci H. Antipsychotiques, neuroleptiques et qualité de vie. Halopsy 1998 ; 19-23-4.
- Carriere P, Bonhomme D, Lemperiere L. Meilleur rapport bénéfice / risque de l'amisulpiride comparé à l'halopéridol dans la schizophrénie : résultats d'une étude multicentrique en double aveugle (groupe d'étude de l'amisulpride ) . Eur Psychiatry2000 ; 15 : 321-6.
- Chouinard G, Margolese HC. Manual for Extrapyramidal Symptom Rating Scale (ESRS). Schizophrenia Res 2005; 76: 247- 65.Errratum in : Schizophrenia Res 2006; 85:305.
- Colonna L, Saleem P, Doney Nouvil L, Rein W. Tolérance et efficacité à long terme de l'amisulpiride dans la schizophrénie chronique ou subchronique . International Clinical Psychopharmacology 2000 ; 15 ;13-22.
- Chambon O, Marie-Cardine M, Cottraux J et al. Impact d'un programme global d'entraînement aux habilités sociales sur le fonctionnement social et la qualité de vie subjective de schizophrènes. Ther Comp Cogn 1995 ; 5 :37-43.
- Corten P. Le concept de “ quality de vie” vu à travers la littérature anglo-saxonne. L'information Psychiatrique 1998 ; 9 : 922-32.
- Divanon F, Delamillieure P, Lehaguez A et al. Comparative evaluation of quality of life in patients with schizophrenia treated with conventional versus atypical neuroleptics: results of a transversal study. L'Encéphale 2006; 32: 459-65.
- Duyme M, Barbeau J, Jolivet B, Dumar A. Maladie mentale, travail et société. Paris : PUF Diffusion, 1987 : 225-8.
- Guillard-Bouhet N, Lafay N, Jourdain M, Senon JL. Comparaison de la réadaptation psychosociale et de la qualité de vie des schizophrènes sous neuroleptique classique ou atypique. L'Encéphale 2005 ; 31 : 653-65.
- Gilles R, Simeoni MC, Auquier P et al. Assessing health-related quality of life in patients suffering from schizophrenia : a comparison of instruments. European Psychiatry 2005; 20: 510-9.
- Lancon C, Auquier P, Launois R et al. Evaluation de la qualité de vie des patients schizophrènes : validation de la version courte de la QOL. L'Encéphale 2000 ; 26 : 11-6.
- Lehman AF. Well being of chronic mental health patients: assessing their quality of life. Arch Gen Psychiatry 1983; 40: 369-73. 18. Mahmoud RA, Engelhart L M, Janagap CC et al. Risperidone versus Conventional Antipsychotics for Schizophrenia and Schizoaffective Disorder : Symptoms, Quality of life and Resource Use under Custmary Clinical Care Clin Drug Investing. 2004; 24: 275-86.
- Martin P. Le concept de qualité de vie. Act Med 1999 ; 16 :4-5.
- Meltzer HV, Burnett S, Bastani B et al. Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hospital and Community Psychiatry 1990; 41: 892-7.
- Noordsy DL, O'keefe C. Effectiveness of combining atypical antipsychotics and psychosocial rehabilitation in a community mental health center setting. J Clin Psychiatry 1999; 60: 47-53.
- Revicki DA, Genduso LA, Hamilton S et al Olanzapine versus haloperidol in the treatment of schizophrenia and other psychotic disorders : quality of life and clinical outcomes of a randomised clinical trial. Quality of life Research 1999; 8: 417-26.
- Rossler W, Salize HJ, Cucchiaro G et al. Does the place of treatment influence the quality of life of schizophrenics. Acta Psychiatr Scand 1999; 100: 142-8.
- Tempier R, Pawliuk N. Influence of new and conventional antipsychotic medication on subject quality of life. Journal of Psychiatry &Neuroscience 2001; 26: 131-6.
- Voruganti L, Cortese L, Oyewumi L et al. Comparative evaluation of conventional and novel antipsychotic drugs reference to their subtjective tolerability, side effect profit and impact to quality of life. Schizophrenia Res 2000; 43: 135-45.
- Wehmeir PM, Kluge M, Schneider E et al. Quality of life and subjective well-being during treatment with antipsychotics in outpatientswith schizophrenia. Prog Neuropsychopharmacol Bio Psychiatry 2007; 31: 703-12.
- Zannotti M.A method for quality of life assessment in psychiatry : the subjective quality of life. Quality of life news letter 1992; 4-6.
- Zhangab PL, Santosc JM, Newcomerab J et al. Impact of atypical antipsychotics on quality of life, self-report of symptom severity, and demand of services in chronically psychotic patients. Schizophrenia Research 2004; 71: 137-4