title: Working alliance and its relationship to outcomes in a randomized controlled trial (RCT) of antipsychotic medication.
abstract: BACKGROUND
  Long acting injections (LAI) have been associated with perceptions of coercion in cross sectional studies but there have been no longitudinal studies of the effects on clinical relationships with newer depot medications.
  
  
  METHODS
  Randomized controlled trial with (50) participants with a diagnosis of schizophrenia randomized to risperidone LAI or oral atypical antipsychotic medication. The main outcome was the Working Alliance Inventory (WAI) with background variables (symptoms, side effect, social functioning, quality of life) measured before randomization and at two years.
  
  
  RESULTS
  At follow-up (14 risperidone LAI and 16 oral medication) analyses including predictors of missing data and baseline score showed a trend for those on risperidone LAI to reduce WAI score and those on oral medication showing no change. Sensitivity analyses showed (i) a significant detrimental effect of LAI on WAI and (ii) the pattern of results was not affected by change in symptoms over the study.
  
  
  CONCLUSIONS
  This is the first study to show that the prescription of depot atypical depot medication is associated with detrimental effects on clinical relationships after 2 years of continual treatment.
authors: NIHR MHRN and Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. til.wykes@kcl.ac.uk
authors: Til
authors: T
authors: Wykes
authors: Diana
authors: D
authors: Rose
authors: Paul
authors: P
authors: Williams
authors: Anthony S
authors: AS
authors: David
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D011788:Quality of Life / Q000523:psychology; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D018967:Risperidone