Subjective distress related to side effects and subjective well-being in first admitted adolescents with early-onset psychosis treated with atypical antipsychotics.
OBJECTIVE
Side effects (SE) of antipsychotics are considered a major source of subjective discomfort. The aim of this pilot study was to evaluate the subjective distress-related to different SE and its association with subjective well-being in a sample of adolescents treated with atypical antipsychotics.


METHODS
Subjects enrolled were first hospitalized adolescent inpatients with diagnoses of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) schizophrenia, schizophreniform, or schizoaffective disorder. Subjects' Clinical Global Impression-Severity (CGI-S) and subjective well-being (SWN-K, BfS) were evaluated at baseline, week 2, and week 6. Side effects (UKU) and subjective distress under SE (Subjective Distress Scale, SDS) were evaluated at weeks 2 and 6.


RESULTS
Twenty adolescents were included. Almost all subjects suffered from at least one distressing SE at both follow-up time points. The mean number of distressing SE decreased from weeks 2 to 6. The most prevalent distressing SE were psychic SE and weight gain. There was an association between distress related to psychic and neurological SE and negative subjective wellbeing (r = 0.60-0.70). Subjective distress with these SE, especially neurological SE at both time points and sedation-increased sleep at week 6, did not correspond to clinician's severity ratings.


CONCLUSIONS
Clinicians may overlook distress by only judging the severity of SE objectively in the treatment with atypical antipsychotics, leading to negative subjective well-being and a high rate of nonadherence to treatment. Therefore, it is recommended to discuss the severity of, and distress with, SE independently with patients. Future studies should focus on distress related to neurological SE, sedation, and weight gain.
Schimmelmann
Benno Graf
BG
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany. bschimme@aol.com
Paulus
Stephanie
S
Schacht
Melanie
M
Tilgner
Christian
C
Schulte-Markwort
Michael
M
Lambert
Martin
M
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004644:Emotions / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception / Q000187:drug effects / Q000502:physiology; D010865:Pilot Projects; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced / Q000523:psychology; D018709:Statistics, Nonparametric; D015430:Weight Gain / Q000187:drug effects / Q000502:physiology
D014150:Antipsychotic Agents