Evaluation of subjective treatment satisfaction with antipsychotics in schizophrenia patients.
Adherence to antipsychotic treatment is particularly important in the long-term management of schizophrenia and other related psychotic disorders since poor adherence to medication is associated with poor health outcomes. Although the patients' subjective satisfaction with the medication is crucial for adherence to medication, few studies have examined the relationship between subjective satisfaction with antipsychotics and adherence. In this study, we investigated subjective satisfaction with antipsychotics in patients with schizophrenia by using the Treatment Satisfaction Questionnaire for Medication (TSQM), a self-reporting instrument to assess the major dimensions of patients' satisfaction with their medication. The subjects included 121 clinically stabilized outpatients who met the following criteria: 1) patients between 20 and 65 years of age, diagnosed with schizophrenia or other psychotic disorders as defined by DSM-IV, 2) patients undergoing oral antipsychotic monotherapy or taking only an antiparkinsonian agent as an adjuvant remedy, and 3) patients who had received a stable dose of an antipsychotic for more than four weeks. Patients were asked to answer the TSQM questions, and their clinical symptoms were also evaluated by the Brief Psychiatric Rating Scale (BPRS). Satisfaction with regard to side-effects (p=0.015) and global satisfaction (p=0.035) were significantly higher in patients taking second-generation antipsychotics (SGAs, n=111) than those taking first-generation antipsychotics (FGAs, n=10), whereas no significant difference was found between the two groups in clinical symptoms according to BPRS (p=0.637) or the Drug-induced Extrapyramidal Symptoms Scale (DIEPSS, p=0.209). In addition, correlations were not significant between the subjective satisfactions and clinician-rated objective measures of the symptoms. These findings suggest that SGAs have more favorable subjective satisfaction profiles than FGAs in the treatment of schizophrenia. Since it is often difficult to detect the difference by a traditional objective assessment of the patients, it is desirable that physicians pay attention to the patients' subjective satisfaction in conjunction with their own objective clinical assessment.
Fujikawa
Midori
M
Department of Psychiatry, Yokohama City University, 3-9 Fukuura, Kanazawa-ku Yokohama 236-0004, Japan. midorimori7@hotmail.co.jp
Togo
Takashi
T
Yoshimi
Asuka
A
Fujita
Junichi
J
Nomoto
Munetaka
M
Kamijo
Atsushi
A
Amagai
Toru
T
Uchikado
Hirotake
H
Katsuse
Omi
O
Hosojima
Hideki
H
Sakura
Yoshihisa
Y
Furusho
Ryo
R
Suda
Akira
A
Yamaguchi
Takayuki
T
Hori
Taketo
T
Kamada
Ayuko
A
Kondo
Taizo
T
Ito
Michitomo
M
Odawara
Toshinari
T
Hirayasu
Yoshio
Y
D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000145:classification / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents