Improvement of Subjective Well-being and Enduring Symptomatic Remission, A 5-Year Follow-up of First Episode Schizophrenia

 

 Buy Article Permissions and Reprints

Abstract

Introduction: The aim of this prospective study was to compare the predictive validity of early improvement of subjective experience and early improvement of rater assessed symptoms on enduring symptomatic remission (ESR) status during 5 years follow.

Methods: 110 consecutively admitted patients suffering from a first episode of schizophrenia or related disorders were investigated. We defined early improvement of subjective well-being as a delta-score of the total Subjective Well-being under Neuroleptics scale-20 item version (SWN-K) at admission and after 6 weeks treatment. The severity of psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS) at admission, 6 weeks, 6 months, 3 and 5 years after admission. Enduring symptomatic remission (ESR) was defined as complying to the symptomatic remission criteria at PANSS assessment at 6 months and 5 years and continuing this state between 6 months and 5 years follow-up. Paired-samples and independent t-test were used to compare means.

Results: Patients with ESR (n=30) had a higher mean improvement of subjective well-being during early treatment as assessed with the SWN-K than those without ESR (n=74) (p=0.004). Early symptomatic improvement as assessed with the PANSS was not related to ESR (p=0.95).

Discussion: Early improvement of subjective well-being is related to ESR in first episode schizophrenia or related disorders.

References

• 1 Andreasen NC, Carpenter Jr WT, Kane JM. et al . Remission in schizophrenia: proposed criteria and rationale for consensus.  Am J Psychiatry. 2005;  162 441-449
  CrossrefPubMedGoogle Scholar
• 2 Haan L De, Weisfelt M, Dingemans PM. et al . Psychometric properties of the subjective well-being under neuroleptics scale and the Subjective Deficit Syndrome Scale.  Psychopharmacology. 2002;  162 24-28
  CrossrefPubMedGoogle Scholar
• 3 Haan L de, Amelsvoort T van, Dingemans P, Linszen D. Risk factors for medication non-adherence in patients with first episode schizophrenia and related disorders; a prospective five year follow-up.  Pharmacopsychiatry. 2007;  40 264-268
  Article in Thieme ConnectPubMedGoogle Scholar
• 4 Karow A, Schnedler D, Naber D. What would the patient choose? Subjective comparison of atypical and typical neuroleptics.  Pharmacopsychiatry. 2006;  39 47-51
  Article in Thieme ConnectPubMedGoogle Scholar
• 5 Karow A, Czekalla J, Dittmann RW, Schacht A, Wagner T, Lambert M, Schimmelmann B, Naber D. Association of subjective well-being, symptoms, and side effects with compliance after 12 months of treatment in schizophrenia.  J Clin Psychiatry. 2007;  68 75-80
  CrossrefPubMedGoogle Scholar
• 6 Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia.  Schizophr Bull. 1987;  13 261-276
  CrossrefPubMedGoogle Scholar
• 7 Lambert M, Schimmelmann BG, Karow A, Naber D. Subjective well-being and initial dysphoric reaction under antipsychotic drugs – concepts, measurement and clinical relevance.  Pharmacopsychiatry. 2003;  36 S181-190
  Article in Thieme ConnectPubMedGoogle Scholar
• 8 Lambert M, Schimmelmann BG, Naber D. et al . Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia.  J Clin Psychiatry. 2006;  67 1690-1697
  CrossrefPubMedGoogle Scholar
• 9 Lambert M, Eich FX, Schacht M, Naber D, Linden M, Schimmelmann BG. Remission of severely impaired subjective well-being in 727 patients with schizophrenia treated with amisulpride.  Acta Psychiatrica Scand. 2007;  115 106-113
  CrossrefPubMedGoogle Scholar
• 10 Leucht S, Lasser R. The concepts of remission and recovery in schizophrenia.  Pharmacopsychiatry. 2006;  39 161-170
  Google Scholar
• 11 Naber D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables.  Int Clin Psychopharmacol. 1995;  10 133-138
  CrossrefPubMedGoogle Scholar
• 12 Os J Van, Drukker M, Campo J. et al Validation of remission criteria for schizophrenia.  Am J Psychiatry. 2006;  163 2000-2002
  CrossrefPubMedGoogle Scholar
• 13 Wehmeier P, Kluge M, Schacht A, Helsberg K, Schreiber W, Lambert M. Patterns of physician and patient rated quality of life during antipsychotic treatment in outpatients with schizophrenia.  J Psychiatric Res. 2007;  , in press
  PubMedGoogle Scholar

Correspondence

L. de Haan

Postbus 75867

1070 AW Amsterdam

The Netherlands

Phone: +31/(0)20/891 37 09

Fax: +31/(0)20/891 37 02

Email: L.deHaan@amc.uva.nl