Patient perspectives on antipsychotic treatments and their association with clinical outcomes

Figures & data

Table 1 Patient demographics and baseline characteristics

Measure	Olanzapine versus haloperidol			Olanzapine versus risperidone			Olanzapine versus ziprasidone
	Olanzapine (n = 211)	Haloperidol (n = 145)	Pvalue	Olanzapine (n = 159)	Risperidone (n = 158)	Pvalue	Olanzapine (n = 277)	Ziprasidone (n = 271)	Pvalue
Age, years, mean (SD)	38.6 (8.4)	39.7 (8.6)	0.20	38.4 (7.9)	39.5 (8.3)	0.23	40.1 (11.6)	38.2 (12.1)	0.07
Age at onset, mean (SD)	22.6 (6.9)	22.0 (7.2)	0.41	23.0 (7.0)	23.3 (7.2)	0.72	23.9 (8.3)	22.8 (8.2)	0.11
Males, %	72.0	71.0	0.90	72.3	70.2	0.71	65.0	63.5	0.72
Racial/ethnic origin, n (%)			0.27			0.31			0.77
African	62 (29.4)	52 (35.9)		43 (27.0)	43 (27.2)		78 (28.2)	66 (24.4)
Caucasian	121 (57.3)	71 (49.0)		95 (59.7)	101 (63.9)		115 (41.5)	124 (45.8)
East Asian	5 (2.4)	2 (1.4)		3 (1.9)	2 (1.3)		2 (0.7)	3 (1.1)
Hispanic	15 (7.1)	11 (7.6)		13 (8.2)	6 (3.8)		63 (22.7)	61 (22.5)
South Asian	2 (1.0)	0 (0.0)		2 (1.3)	0 (0.0)		1 (0.4)	0 (0.0)
Other	6 (2.8)	9 (6.2)		3 (1.9)	6 (3.8)		18 (6.5)	17 (6.3)
Diagnosis, n (%)			0.96			0.14			–
Schizophrenia	135 (64.0)	94 (64.8)		105 (66.0)	117 (74.0)		277 (100.0)	271 (100.0)
Schizoaffective	75 (35.6)	50 (34.5)		54 (34.0)	41 (26.0)		0 (0.0)	0 (0.0)
Schizophreniform	1 (0.5)	1 (0.7)		0 (0.0)	0 (0.0)		0 (0.0)	0 (0.0)
Baseline PANSS total, mean (SD)	87.2 (16.5)	88.5 (17.6)	0.47	82.6 (13.1)	84.2 (14.7)	0.32	99.8 (19.1)	102.0 (21.2)	0.19
Mean modal dose (mg/day), mean	14.0	16.4	–	12.3	5.2	–	15.3	116.0	–

Abbreviations: PANSS, Positive and Negative Syndrome Scale; SD, standard deviation.

Table 2 Changes in Positive and Negative Syndrome Scale total and subscale scores at endpoint, by treatment

PANSS scale	Olanzapine versus haloperidol			Olanzapine versus risperidone			Olanzapine versus ziprasidone
	Olz	Hal	Pvalue	Olz	Ris	Pvalue	Olz	Zip	Pvalue
Total	−16.7	−12.6	0.011	−12.4	−9.5	0.054	−35.7	−26.0	<0.001
Depressive	−2.3	−1.7	0.012	−2.0	−1.6	0.18	−3.9	−3.0	<0.001
Disorganized thought	−2.8	−2.1	0.025	−1.9	−1.3	0.011	−6.0	−4.1	<0.001
Hostility	−2.0	−1.8	0.26	−0.9	−0.6	0.54	−4.2	−2.6	<0.001
Negative	−3.1	−2.1	0.07	−2.6	−1.8	0.10	−8.4	−6.7	<0.001
Positive	−6.4	−5.1	0.08	−5.1	−4.2	0.19	−13.2	−9.6	<0.001

Abbreviations:Hal, haloperidol; Olz, olanzapine; PANSS, Positive and Negative Syndrome Scale; Ris, risperidone; Zip, ziprasidone.

Table 3 Drug Attitude Inventory items, percent agreeing at endpoint, by treatment

DAI item	Olanzapine versus haloperidol			Olanzapine versus risperidone			Olanzapine versus ziprasidone
	Olz	Hal	Pvalue	Olz	Ris	Pvalue	Olz	Zip	Pvalue
01: Good outweighs bad	86.3	75.8	0.022	84.4	73.7	0.036	86.5	82.4	0.26
02: Feel weird, like a “zombie”	17.9	35.0	0.001	17.0	20.3	0.53	18.0	25.8	0.037
03: Take meds of own free choice	88.6	86.9	0.72	87.4	84.2	0.49	84.1	80.4	0.34
04: Feel more relaxed	84.8	68.0	0.001	85.2	75.2	0.046	79.2	76.3	0.45
05: Feel tired/sluggish	37.5	50.8	0.025	37.0	39.8	0.71	30.7	35.8	0.25
06: Take meds only when sick	59.2	53.7	0.35	64.4	66.9	0.70	35.5	31.4	0.39
07: Feel more normal	83.5	64.8	<0.001	83.7	75.9	0.13	74.3	72.5	0.68
08: Unnatural to be controlled by meds	39.1	39.2	>0.99	34.1	37.6	0.61	38.4	37.9	0.93
09: Clearer thoughts	81.0	66.9	0.007	81.5	78.9	0.65	74.3	77.1	0.53
10: Med prevents sickness	85.9	77.0	0.07	85.9	78.2	0.11	81.6	82.1	0.91

Abbreviations: DAI, Drug Attitude Inventory; Hal, haloperidol; Olz, olanzapine; Ris, risperidone; Zip, ziprasidone.

Figure 1 Completion rates, by endpoint Drug Attitude Inventory response for all patients. Patients with a positive attitude toward their medication had a greater likelihood of completing their treatment (*P < 0.05; ***P < 0.001).

Table 4 Positive and Negative Syndrome Scale subscale score changes, by endpoint Drug Attitude Inventory response for all patients

DAI item	Resp.	Depressive		Disorg. Tht.		Hostility		Negative		Positive
		Mean (SD)	Pvalue	Mean (SD)	Pvalue	Mean (SD)	Pvalue	Mean (SD)	Pvalue	Mean (SD)	Pvalue
Good outweighs bad	No	−1.6 (4.0)	<0.001	−2.1 (5.0)	<0.001	−1.0 (4.9)	<0.001	−2.6 (6.8)	<0.001	−4.6 (8.5)	<0.001
	Yes	−3.2 (3.8)		−4.4 (4.9)		−2.6 (4.4)		−6.2 (7.3)		−10.0 (9.3)
Feel weird, like a “zombie”	No	−3.3 (3.9)	<0.001	−4.3 (5.0)	<0.001	−2.5 (4.6)	0.014	−6.1 (7.4)	<0.001	−10.0 (9.3)	<0.001
	Yes	−1.8 (3.6)		−2.9 (5.0)		−1.7 (4.5)		−3.5 (6.8)		−6.4 (9.4)
Take meds of own free choice	No	−2.8 (4.0)	0.59	−3.6 (4.8)	0.32	−1.9 (4.9)	0.25	−4.3 (7.3)	0.024	−8.0 (9.6)	0.10
	Yes	−3.0 (3.9)		−4.1 (5.0)		−2.4 (4.5)		−5.8 (7.3)		−9.5 (9.4)
Feel more relaxed	No	−2.0 (4.0)	<0.001	−2.7 (4.8)	<0.001	−1.3 (4.9)	<0.001	−3.5 (7.6)	<0.001	−6.2 (8.7)	<0.001
	Yes	−3.2 (3.8)		−4.4 (5.0)		−2.6 (4.4)		−6.2 (7.2)		−10.0 (9.5)
Feel tired/sluggish	No	−3.4 (4.0)	<0.001	−4.6 (5.1)	<0.001	−2.7 (4.6)	<0.001	−6.6 (7.6)	<0.001	−10.0 (9.4)	<0.001
	Yes	−2.2 (3.7)		−3.0 (4.8)		−1.7 (4.5)		−3.8 (6.6)		−7.1 (9.2)
Take meds only when sick	No	−3.2 (3.9)	0.06	−4.7 (5.2)	<0.001	−2.9 (4.7)	<0.001	−6.8 (7.4)	<0.001	−11.0 (9.8)	<0.001
	Yes	−2.7 (3.9)		−3.2 (4.7)		−1.7 (4.4)		−4.2 (7.0)		−7.3 (8.7)
Feel more normal	No	−2.2 (4.5)	<0.001	−2.9 (5.2)	<0.001	−1.4 (5.3)	<0.001	−3.9 (7.3)	<0.001	−6.3 (9.6)	<0.001
	Yes	−3.2 (3.7)		−4.4 (4.9)		−2.7 (4.3)		−6.1 (7.3)		−10.0 (9.2)
Unnatural to be controlled by meds	No	−3.0 (4.0)	0.58	−3.9 (5.1)	0.47	−2.4 (4.4)	0.89	−5.9 (7.6)	0.052	−9.4 (9.6)	0.62
	Yes	−2.9 (3.8)		−4.2 (4.9)		−2.3 (4.9)		−5.0 (6.9)		−9.1 (9.3)
Clearer thoughts	No	−2.1 (4.3)	<0.001	−2.5 (4.6)	<0.001	−1.1 (4.6)	<0.001	−3.6 (6.5)	<0.001	−5.8 (8.8)	<0.001
	Yes	−3.2 (3.7)		−4.5 (5.1)		−2.7 (4.5)		−6.2 (7.5)		−10.0 (9.4)
Med prevents sickness	No	−2.0 (4.4)	<0.001	−2.3 (5.2)	<0.001	−1.0 (4.6)	<0.001	−3.7 (7.2)	<0.001	−5.6 (8.9)	<0.001
	Yes	−3.2 (3.7)		−4.4 (4.9)		−2.6 (4.5)		−6.0 (7.3)		−10.0 (9.4)

P value difference between percentages of patients responding “yes” or “no,” using Fisher’s Exact test.

Abbreviations: DAI, Drug Attitude Inventory; Disorg. Tht, disorganized thought subscale; SD, standard deviation; Resp, response.