Quality of life and subjective well-being in schizophrenia and schizophrenia spectrum disorders: Valid predictors of symptomatic response and remission?

Abstract

Objectives. To examine quality of life and subjective well-being as predictors of symptomatic treatment outcome. Methods. Biweekly PANSS ratings were performed in 285 inpatients with schizophrenia spectrum disorders within a multicenter trial by the German Research Network on Schizophrenia. Quality of life and subjective well-being were assessed using the Medical Outcomes Study-Short Form 36-Item Health Survey (SF-36), the Subjective Well-being Under Neuroleptic Treatment Scale (SWN-K) and the Adjective Mood Scale (AMS). Response was defined as an initial 20% PANSS total score reduction and remission according to the consensus criteria. Correlation analysis, logistic regression and CART-analysis were performed. Results. In total, 81% of the sample achieved symptom response and 48% symptom remission. The statistical analyses revealed early improvement within the first two treatment weeks in the SWN-K scale to be a significant predictor for symptomatic response. Concerning symptomatic remission the SF-36 and SWN-K baseline scores as well as SWN-K early improvement showed significant predictive value. Conclusions. These results highlight the importance of the patient's self-perception and especially of early improvement of quality of life and subjective well-being for symptomatic treatment outcome.

Key words::

• Schizophrenia
• response and remission
• prediction
• quality of life
• subjective well-being

Acknowledgements

The study was performed within the framework of the German Research Network on Schizophrenia, which is funded by the German Federal Ministry for Education and Research BMBF (grant 01 GI 0233). The network study was conducted at 14 psychiatric hospitals: Aachen (P. Hoff, K. Podoll), Augsburg (M. Schmauß, T. Messer, M. Eichinger), Berlin (I. Heuser, M. Jockers-Scherübl), Bonn (W. Maier, K.-U. Kühn, M.R. Lemke, R. Hurlemann, W.P. Hornung, E. Rosen), Cologne (J. Klosterkötter, W. Huff,), Düsseldorf (W. Gaebel, A. Klimke, M. Eickhoff, M. von Wilmsdorff), Essen (M. Gastpar, V. Reißner), Gabersee (G. Laux, B. Hermann, B. Pflichta), Göttingen (E. Rüther, D. Degner), Haar (H. Pfeiffer, M. Albus, S. Scharf-Büssing), Hamburg (D. Naber, D. Golks), Mainz (L.G. Schmidt, B. Kaufmann-Grebe), Munich (H.J. Möller, R. Bottlender, M. Riedel, M. Jäger, C. Schorr, B. Schillinger, C. Mirlach), Tübingen (G. Buchkremer, M. Mayenberger).

Statement of interest

The authors have no conflict of interest with any commercial or other associations in connection with the submitted article.