title: Antipsychotic polypharmacy in schizophrenia patients in China and its association with treatment satisfaction and quality of life: findings of the third national survey on use of psychotropic medications in China.
abstract: OBJECTIVE
  This study examined the use, demographic and clinical correlates of antipsychotic polypharmacy (APP) and its associations with treatment satisfaction and quality of life (QOL) in schizophrenia patients in China.
  
  
  METHODS
  A total of 4239 patients in 45 nationwide Chinese psychiatric hospitals/centers were interviewed in 2012 in the third cross-sectional study, with the first two having been conducted in 2002 and 2006. Patients' socio-demographic and clinical characteristics, including psychopathology, side effects, satisfaction with treatment and QOL, were recorded using a standardized protocol and data collection procedure.
  
  
  RESULTS
  The proportion of APP prescriptions in 2012 was 34.2%, which was significantly higher than the frequency of APP in 2002 (26.1%) and 2006 (26.4%) (p<0.001). Of patients on APP, 91.1% received two antipsychotics, 8.6% received three and 0.3% received four or more antipsychotics. Multiple logistic regression analyses revealed that compared to those on antipsychotic monotherapy, patients on APP and their families had lower satisfaction with treatment, had higher QOL in the mental domain, younger age of onset, more side effects, higher doses of antipsychotics and were more likely to receive first-generation antipsychotics and less likely to receive benzodiazepines (total R (2)=0.31, p<0.001).
  
  
  CONCLUSIONS
  APP was found in about one in three schizophrenia patients. The prevalence of APP seems to have been increasing since 2002. Considering the increased frequency of drug-induced side effects and the patients' and their relatives' dissatisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of APP and its alternatives is warranted.
authors.affiliation: The Key Laboratory of Mental Health, Ministry of Health & Peking University Institute of Mental Health, Beijing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: The Key Laboratory of Mental Health, Ministry of Health & Peking University Institute of Mental Health, Beijing, China.
authors.forename: Yun-Ai
authors.initials: YA
authors.lastname: Su
authors.affiliation: The Key Laboratory of Mental Health, Ministry of Health & Peking University Institute of Mental Health, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Shu
authors.affiliation: The Key Laboratory of Mental Health, Ministry of Health & Peking University Institute of Mental Health, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Helen Fk
authors.initials: HF
authors.lastname: Chiu
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: The University of Notre Dame Australia/Marian Centre, Perth, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Kelly Yc
authors.initials: KY
authors.lastname: Lai
authors.affiliation: Psychiatric Hospital, Guangzhou, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Ma
authors.affiliation: Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, China.
authors.forename: Gao-Hua
authors.initials: GH
authors.lastname: Wang
authors.affiliation: The First Hospital of Shanxi Medical University, Shanxi Province, China.
authors.forename: Pei-Shen
authors.initials: PS
authors.lastname: Bai
authors.affiliation: West China Hospital, Sichuan University, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.affiliation: Neuropsychiatric Hospital, Jilin, China.
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Sun
authors.affiliation: Mental Health Center, Xi-an, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Shi
authors.affiliation: Jiangxi Psychiatric Hospital, Jiangxi, China.
authors.forename: Xian-Sheng
authors.initials: XS
authors.lastname: Chen
authors.affiliation: Suzhou Guangji Hospital, Suzhou, China.
authors.forename: Qi-Yi
authors.initials: QY
authors.lastname: Mei
authors.affiliation: Hebei Mental Health Center, Hebei, China.
authors.forename: Ke-Qing
authors.initials: KQ
authors.lastname: Li
authors.affiliation: The Key Laboratory of Mental Health, Ministry of Health & Peking University Institute of Mental Health, Beijing, China si.tian-mei@163.com.
authors.forename: Tian-Mei
authors.initials: TM
authors.lastname: Si
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019338:Polypharmacy; D011788:Quality of Life / Q000523:psychology*; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotic polypharmacy; prescription patterns; schizophrenia