Predictors of treatment satisfaction in antipsychotic-naïve and previously medicated patients with acute-phase psychosis

Abstract

Background: Treatment satisfaction predicts treatment adherence and long-term outcome for patients with psychosis. It is therefore important to understand the underpinnings of patient satisfaction in psychosis treatment for optimal treatment delivery.

Aims: To examine the associations between satisfaction and level and change in positive symptoms, insight, depression and side effects of antipsychotics in previously medicated and antipsychotic-naïve patients.

Method: Data derive from a randomised trial, with 226 respondents at baseline and 104 at follow-up. The measures were the positive subscale and insight item from the Positive and Negative Syndrome Scale, Calgary Depression Scale, the UKU Consumer Satisfaction Rating Scale, and the UKU side effects scale. Structural equation modelling was used to test the model. The full information maximum likelihood estimator used all available data.

Results: In the sample of 226 patients, 67.3% were male and 44.2% were antipsychotic-naïve. The mean age was 34.1 years. For previously medicated patients, satisfaction was predicted by level of insight (b = −2.21, β = −0.42) and reduction in positive symptoms (b = −0.56, β = −0.39). For antipsychotic-naïve patients, satisfaction was predicted by level and change of insight (b = −2.21, β = −0.46), change in depression (b = −0.37, β = −0.26) and side effects (b = −0.15, β = −0.30). All predictors were significant at the 0.05 level.

Conclusion: Reducing positive symptoms and side effects are important to enhance patient satisfaction. However, improving insight and reducing depression are more important in antipsychotic-naïve patients.

Trial registration: ClinicalTrials.gov identifier: NCT00932529.

Keywords:

• Acute-phase psychosis
• patient satisfaction
• hospitalisation
• antipsychotic-naïve
• insight
• depression

Acknowledgments

The author would like to give thanks to Povl Munk-Jørgensen and the rest of the scientific writing group for valuable guidance and support while drafting this manuscript.

Trial registration

ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/:NCT00932529

Disclosure statement

The BPP study was publicly funded and did not receive any financial or other support from the pharmaceutical industry. None of the authors declare any conflict of interest related to the present work.

Additional information

Notes on contributors

Lena Antonsen Stabell

Lena Antonsen Stabell Mental Health Nurse, M.sc. AoE: Clinical psychiatry.

Rolf Gjestad

Rolf Gjestad Psychologist, PhD, advisor in statistical analysis. AoE: Clinical psychology and statistical analysis.

Rune A. Kroken

Rune Andreas Kroke MD, PhD, Psychiatrist, ass. Professor. AoE: Clinical psychitatry and pharmacology.

Else-Marie Løberg

Else-Marie Løberg PhD, Specialist in Clinical Psychology, Professor. AoE: Neurocognition, clinical psychology, illicit drug abuse research.

Hugo A. Jørgensen

Hugo Jørgense MD, PhD, Psychiatrist, Professor Emeritus. AoE: Clinical psychiatry and pharmacology, basic- and clinical research.

Erik Johnsen

Erik Johnsen MD, PhD, Psychiatrist, Professor. Area of expertise (AoE): Clinical psychiatry and pharmacology, clinical trial conductance.