Associations of Clozapine Use With Psychosocial Functioning and Quality of Life in Patients With Schizophrenia: A Community-Based Cross-Sectional Study
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective More attempts have been made recently to improve psychosocial functioning and quality of life in patients with schizophrenia, due to their crucial role in long-term outcomes. Previous studies on the effects of clozapine on psychosocial functioning have been limited in terms of generalizability and application to clinical practice. This study examined the relationship of clozapine use with psychosocial functioning and quality of life in patients with schizophrenia in a real-world setting.Methods Data were obtained from a survey targeting community-dwelling patients with schizophrenia. The Behavior and Symptom Identification Scale (BASIS) and Satisfaction with Life Scale (SWLS) were administered to evaluate psychosocial functioning and quality of life, and patients were classified into Clozapine and Non-clozapine groups. Group differences were assessed using ANCOVA, with additional sensitivity analyses for participants on atypical antipsychotic medications only.Results Of 292 patients, the Clozapine group (n=34) had significantly better psychosocial functioning and quality of life than the Nonclozapine group (n=258), as demonstrated by their low BASIS score (F=4.651, df=1, 290, p=0.032) and high SWLS score (F=14.637, df=1, 290, p<0.001). Similar findings for psychosocial outcomes were observed in the analyses of the atypical antipsychotic subgroup (n=195).Conclusion For optimal recovery in schizophrenia, restoration of impaired social functioning and enhanced satisfaction with life are essential. In this study, clozapine use was related to high levels of psychosocial functioning and quality of life in real-world settings. Further research on the causal relationship between clozapine use and psychosocial functioning is needed.
Abstract
Objective More attempts have been made recently to improve psychosocial functioning and quality of life in patients with schizophrenia, due to their crucial role in long-term outcomes. Previous studies on the effects of clozapine on psychosocial functioning have been limited in terms of generalizability and application to clinical practice. This study examined the relationship of clozapine use with psychosocial functioning and quality of life in patients with schizophrenia in a real-world setting.Methods Data were obtained from a survey targeting community-dwelling patients with schizophrenia. The Behavior and Symptom Identification Scale (BASIS) and Satisfaction with Life Scale (SWLS) were administered to evaluate psychosocial functioning and quality of life, and patients were classified into Clozapine and Non-clozapine groups. Group differences were assessed using ANCOVA, with additional sensitivity analyses for participants on atypical antipsychotic medications only.Results Of 292 patients, the Clozapine group (n=34) had significantly better psychosocial functioning and quality of life than the Nonclozapine group (n=258), as demonstrated by their low BASIS score (F=4.651, df=1, 290, p=0.032) and high SWLS score (F=14.637, df=1, 290, p<0.001). Similar findings for psychosocial outcomes were observed in the analyses of the atypical antipsychotic subgroup (n=195).Conclusion For optimal recovery in schizophrenia, restoration of impaired social functioning and enhanced satisfaction with life are essential. In this study, clozapine use was related to high levels of psychosocial functioning and quality of life in real-world settings. Further research on the causal relationship between clozapine use and psychosocial functioning is needed.
참고문헌 (45)
- Brissos S, "The importance of measuring psychosocial functioning in schizophrenia", Ann Gen Psychiatry, 10, pp.1~7 (2011)
- Andreasen NC, "Remission in schizophrenia : proposed criteria and rationale for consensus", Am J Psychiatry, 162, pp.441~449 (2005)
- Shrivastava A, "Redefining outcome measures in schizophrenia : integrating social and clinical parameters", Curr Opin Psychiatry, 23, pp.120~126 (2010)
- Juckel G, "The new approach : psychosocial functioning as a necessary outcome criterion for therapeutic success in schizophrenia", Curr Opin Psychiatry, 21, pp.630~639 (2008)
- Kwon JS, "Social functioning and quality of life as measures of effectiveness in the treatment of schizophrenia", World Psychiatry, 8, pp.35~36 (2009)
- Priebe S, "Social outcomes in schizophrenia", Br J Psychiatry, 191, pp.s15~ (2007)
- Olagunju AT, "Clozapine and psychosocial function in schizophrenia : a systematic review and meta-analysis", CNS Drugs, 32, pp.1011~1023 (2018)
- Ro E, "Psychosocial functioning in the context of diagnosis : assessment and theoretical issues", Psychol Assess, 21, pp.313~324 (2009)
- Swartz MS, "Effects of antipsychotic medications on psychosocial functioning in patients with chronic schizophrenia : findings from the NIMH CATIE study", Am J Psychiatry, 164, pp.428~436 (2007)
- Hunter R, "Negative symptoms and psychosocial functioning in schizophrenia : neglected but important targets for treatment", Eur Psychiatry, 27, pp.432~436 (2012)
- McGurk SR, "The effects of clozapine on cognitive functioning in schizophrenia", J Clin Psychiatry, 60, pp.24~29 (1999)
- Siskind D, "Clozapine v. firstand second-generation antipsychotics in treatment-refractory schizophrenia : systematic review and meta-analysis", Br J Psychiatry, 209, pp.385~392 (2016)
- Volavka J, "Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder", Am J Psychiatry, 159, pp.255~262 (2002)
- Bellack AS, "Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMHsponsored workshop", Schizophr Bull, 33, pp.805~822 (2007)
- Bromley E, "Behavioral Neurobiology of Schizophrenia and Its Treatment", pp.3~21 (2010), Springer
- Essock SM, "Clozapine’s effectiveness for patients in state hospitals : results from a randomized trial", Psychopharmacol Bull, 32, pp.683~697 (1996)
- Rosenheck R, "A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia", N Engl J Med, 337, pp.809~815 (1997)
- Buchanan RW, "Positive and negative symptom response to clozapine in schizophrenic patients with and without the deficit syndrome", Am J Psychiatry, 155, pp.751~760 (1998)
- Wahlbeck K, "Risperidone versus clozapine in treatment-resistant schizophrenia : a randomized pilot study", Prog Neuropsychopharmacol Biol Psychiatry, 24, pp.911~922 (2000)
- Zhang C, "Effectiveness of antipsychotic drugs for 24-month maintenance treatment in first-episode schizophrenia : evidence from a community-based"realworld"study", J Clin Psychiatry, 77, pp.1460~1466 (2016)
- Olagunju AT, "Long-acting atypical antipsychotics in schizophrenia : a systematic review and meta-analyses of effects on functional outcome", Aust N Z J Psychiatry, 53, pp.509~527 (2019)
- Andreasen NC, "Antipsychotic dose equivalents and dose-years : a standardized method for comparing exposure to different drugs", Biol Psychiatry, 67, pp.255~262 (2010)
- Inada T, "Psychotropic dose equivalence in Japan", Psychiatry Clin Neurosci, 69, pp.440~447 (2015)
- Kroken RA, "Treatment of schizophrenia with antipsychotics in Norwegian emergency wards, a cross-sectional national study", BMC Psychiatry, 9, pp.24~ (2009)
- Overall JE, "The brief psychiatric rating scale", Psychol Rep, 10, pp.799~812 (1962)
- Eisen SV, "Assessing behavioral health outcomes in outpatient programs : reliability and validity of the BASIS-32", J Behav Health Serv Res, 26, pp.5~17 (1999)
- Hwang T, "A study on the validity and reliability of the Korean version of behavior and symptom identification scale(BASIS-32)", Bull Yong-In Psychiatr Inst, 7, pp.49~60 (2000)
- Diener E, "The satisfaction with life scale", J Pers Assess, 49, pp.71~75 (1985)
- Pavot W, "Assessing Well-Being", pp.101~117 (2009), Springer
- Gallego JA, "Prevalence and correlates of antipsychotic polypharmacy : a systematic review and metaregression of global and regional trends from the 1970s to 2009", Schizophr Res, 138, pp.18~28 (2012)
- Black N, "Why we need observational studies to evaluate the effectiveness of health care", BMJ, 312, pp.1215~1218 (1996)
- Gilbody S, "Randomized controlled trials in schizophrenia : a critical perspective on the literature", Acta Psychiatr Scand, 105, pp.243~251 (2002)
- Hotopf M, "Pragmatic randomised controlled trials in psychiatry", Br J Psychiatry, 175, pp.217~223 (1999)
- Smart S, "Predictors of treatment resistant schizophrenia : a systematic review of prospective observational studies", Psychol Med, 51, pp.44~53 (2021)
- Galletly C, "Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders", Aust N Z J Psychiatry, 50, pp.410~472 (2016)
- Remington G, "Guidelines for the pharmacotherapy of schizophrenia in adults", Can J Psychiatry, 62, pp.604~616 (2017)
- Demjaha A, "Dopamine synthesis capacity in patients with treatment-resistant schizophrenia", Am J Psychiatry, 169, pp.1203~1210 (2012)
- DOPA PET study, "Neuropsychopharmacology", 2017, 941~950
- Agid O, "Early use of clozapine for poorly responding first-episode psychosis", J Clin Psychopharmacol, 27, pp.369~373 (2007)
- Tungaraza TE, "Clozapine prescribing in the UK : views and experience of consultant psychiatrists", Ther Adv Psychopharmacol, 5, pp.88~96 (2015)
- Xu SW, "Clozapine prescription pattern in patients with schizophrenia in Asia : The REAP survey(2016)", Psychiatry Res, 287, pp.112271~ (2020)
- Meltzer HY, "Treatment-resistant schizophrenia-the role of clozapine", Curr Med Res Opin, 14, pp.1~20 (1997)
- Siskind D, "Clozapine response rates among people with treatment-resistant schizophrenia : data from a systematic review and meta-analysis", Can J Psychiatry, 62, pp.772~777 (2017)
- Chakos MH, "Special section on CATIE baseline data : baseline use of concomitant psychotropic medications to treat schizophrenia in the CATIE trial", Psychiatr Serv, 57, pp.1094~1101 (2006)
- Meltzer HY, "A prospective study of clozapine in treatment-resistant schizophrenic patients", Psychopharmacology(Berl), 99, pp.S68~ (1989)