Quality of life in schizophrenia on conventional versus atypical antipsychotic medication: a comparative cross-sectional study.
BACKGROUND
Atypical antipsychotic drugs, with superior tolerability and possibly superior efficacy, were expected to give schizophrenia patients better quality of life (QOL) than conventional treatment. Research findings are equivocal.


METHODS
We evaluated QOL using three subjective measures--Drug Attitude Inventory (DAI); Sickness Impact Profile (SIP); Schizophrenia Quality of Life Scale (SQLS)--in 126 routinely seen patients whose treatment was stable for six months, regardless of co-morbidity, current clinical status and concomitant medications. Severity of disorder was assessed with the Global Assessment Schedule (GAS).


RESULTS
Fifty patients were on conventional treatment and 76 on atypical treatment. Atypical patients were more likely to be abusing substances (p = 0.02) and living independently (p = 0.00). Conventionally treated patients were older than atypically treated patients. Conventionally treated patients suffered schizophrenia almost twice as long as atypically treated patients. Atypically treated patients enjoyed substantially better quality of life than conventionally treated patients on all measures. The effects of confounding variables, i.e. age, duration, accommodation, co-morbid substance misuse and time spent in hospital, were evaluated with the General Linear Model. This confirmed the status of drug treatment as the primary predictor of all aspects of QOL.


CONCLUSIONS
We conclude that quality of life is genuinely superior on atypical treatment even allowing for the confounding effects of differential prescribing habits: atypical treatment tends to be reserved for younger, less seriously ill patients. There is no scientific or clinical rationale to support this practice.
Mortimer
Ann M
AM
Department of Psychiatry, University of Hull, UK.
Al-Agib
Ahmed Omar Ahmed
AO
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001294:Attitude to Health; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003702:Delusions / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D018434:Sickness Impact Profile; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology; D016896:Treatment Outcome; D006113:United Kingdom
D014150:Antipsychotic Agents