Self- and caregiver-perceived disability, subjective well-being, quality of life and psychopathology improvement in long-acting antipsychotic treatments: a 2-year follow-up study

Abstract

Objective

Switching to long-acting injectable (LAI) antipsychotic maintenance treatment (AMT) represents a valuable strategy for schizophrenia. In a recovery-oriented approach, patient-reported outcomes (PROs) such as perceived disability, subjective well-being, and quality of life cannot be neglected.

Methods

Forty clinically stable outpatients with schizophrenia treated with oral second-generation antipsychotics were enrolled at the time of switching to the equivalent dose of LAI. 35 subjects completed this 2-year longitudinal, prospective, open-label, observational study. Patients were assessed at baseline, after 1 year, and after 2 years of LAI-AMT, using psychometric scales (Positive And Negative Syndrome Scale, PANSS; Young Mania Rating Scale, YMRS; Montgomery-Åsberg Depression Rating Scale, MADRS), PROs (Subjective Well-Being under Neuroleptics short form, SWN-K; Short Form-36 health survey, SF-36; 12-item World Health Organisation Disability Assessment Schedule, WHODAS 2.0), and caregiver-reported outcomes (12-item WHODAS 2.0).

Results

No psychotic relapses were observed. Psychopathology measures (PANSS total and subscales – excluding negative symptoms), mood symptoms (YMRS, MADRS), perceived disability (patient- and caregiver-administered WHODAS 2.0), subjective well-being (SWN-K), and quality of life (SF-36) showed a concomitant amelioration after 1 year, without further significant variations.

Discussion

Switching to LAI-AMT may decrease perceived impairment, and increase subjective well-being and quality of life in clinically stable outpatients with schizophrenia.

Highlights

• LAI treatment may improve outcomes by reducing psychopathology levels and relapses.

• In a recovery-oriented approach, patient-reported outcomes cannot be neglected.

• LAI antipsychotics may optimise the subjective experience of treatment.

• Switching to LAI therapy may result in a reduction in perceived disability.

• There is a significant correlation between proxy- and patient-reported disability.

Keywords:

• Schizophrenia
• LAI
• subjective experience
• quality of life
• patient-reported outcomes
• disability

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The database underlying the present article will be made available on reasonable request to the corresponding author.