Physician observations and perceptions of positive and negative symptoms of schizophrenia: a multinational, cross-sectional survey.
OBJECTIVE
To describe physicians' observations and perceptions of patients with schizophrenia and to obtain information about antipsychotic prescribing practices.


METHODS
Psychiatrists in the United States and five European countries (France, Germany, Italy, Spain, and the United Kingdom) who prescribed antipsychotics for >or=15 patients with schizophrenia within the preceding 3 months provided data on their patients' demographic and clinical characteristics and their antipsychotic prescribing practices and drug attributes influencing treatment choice.


RESULTS
Data were collected from 872 physicians on 6523 patients (85% European, 15% US). Most patients were aged 25-44 years, 63% were men, and 66% were outpatients. About 50% of patients were moderately to grossly dysfunctional; about 50% were unemployed; 34% and 75% were taking conventional or atypical antipsychotics, respectively. Frequently identified positive symptoms included delusions (73%), disordered thought (59%), and hallucinations (59%); common negative symptoms included social withdrawal (54%), impoverished thought (39%), and blunted affect (38%). Reasons for antipsychotic selection included efficacy for positive (90%) or negative symptoms (62%) and tolerability (47%). Inadequate control was reported more frequently for negative (71-77%) than positive (47-60%) symptoms. Adverse events included sedation, weight gain, and extrapyramidal symptoms.


CONCLUSIONS
In this large, multinational, cross-sectional survey, physicians reported that positive symptoms were more common than negative symptoms. Treatment for positive symptoms was more successful than that for negative symptoms, with physicians considering treatment inadequate for >70% of patients with negative symptoms.
Lecrubier
Yves
Y
Unité INSERM 302, Pavillon Clérambault, Hôpital Pitié Salpêtrière, 47 Boulevard de l'Hôpital, F-75013 Paris, France. lecru@ext.jussieu.fr
Perry
Richard
R
Milligan
Gary
G
Leeuwenkamp
Oscar
O
Morlock
Robert
R
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003702:Delusions / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents