Treatment of Schizophrenia Evaluated Via the Pharmacopsychometric Triangle-An Integrative Approach with Emphasis on Well-being and Functioning

Overview

Journal Schizophrenia (Heidelb)

Date 2023 Dec 16

PMID 38104195

Authors

Pernille Kolbaek

Ole Mors

Christoph U Correll

Soren D Ostergaard

Affiliations

Soon will be listed here.

Abstract

Quantification of treatment response is crucial to optimize outcomes for patients with schizophrenia. In this study, we evaluated the relationship between quantitative measures of clinician-rated symptom severity and self-rated side effects, well-being, and functioning among inpatients with schizophrenia using the six-item version of the Positive and Negative Syndrome Scale (PANSS-6), the Glasgow Antipsychotic Side-effect Scale (GASS), the WHO-Five Well-being Index (WHO-5), and the Sheehan Disability Scale (SDS). All measurements were conducted as close to admission and discharge as possible. Well-being and functioning were found to be most strongly associated with the additive effect of symptoms and side effects, while changes in side effects, well-being, and functioning appeared to be relatively independent from changes in symptom severity. The use of both symptom and side effect measures should inform clinical decision-making in the treatment of schizophrenia, as it has the potential to optimize functioning and well-being.

References

Bech P, Gefke M, Lunde M, Lauritzen L, Martiny K . The Pharmacopsychometric Triangle to Illustrate the Effectiveness of T-PEMF Concomitant with Antidepressants in Treatment Resistant Patients: A Double-Blind, Randomised, Sham-Controlled Trial Revisited with Focus on the Patient-Reported Outcomes. Depress Res Treat. 2011; 2011:806298. PMC: 3123910. DOI: 10.1155/2011/806298. View

Ostergaard S, Meyers B, Flint A, Mulsant B, Whyte E, Ulbricht C . Measuring psychotic depression. Acta Psychiatr Scand. 2013; 129(3):211-20. PMC: 3819398. DOI: 10.1111/acps.12165. View

Correll C, Kishimoto T, Nielsen J, Kane J . Quantifying clinical relevance in the treatment of schizophrenia. Clin Ther. 2011; 33(12):B16-39. PMC: 3298768. DOI: 10.1016/j.clinthera.2011.11.016. View

Endicott J, Spitzer R, Fleiss J, Cohen J . The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976; 33(6):766-71. DOI: 10.1001/archpsyc.1976.01770060086012. View

Waddell L, Taylor M . A new self-rating scale for detecting atypical or second-generation antipsychotic side effects. J Psychopharmacol. 2008; 22(3):238-43. DOI: 10.1177/0269881107087976. View

Kolbaek P, Blicher A, Buus C, Feller S, Holm T, Dines D . Inter-rater reliability of ratings on the six-item Positive and Negative Syndrome Scale (PANSS-6) obtained using the Simplified Negative and Positive Symptoms Interview (SNAPSI). Nord J Psychiatry. 2018; 72(6):431-436. DOI: 10.1080/08039488.2018.1492014. View

Kolbaek P, Dines D, Holm T, Blicher A, Sorensen R, OLeary K . Clinical validation of ratings on the six-item Positive and Negative Syndrome Scale obtained via the Simplified Negative and Positive Symptoms Interview. J Psychopharmacol. 2021; 35(9):1081-1090. DOI: 10.1177/0269881121996890. View

Priebe S, McCabe R, Junghan U, Kallert T, Ruggeri M, Slade M . Association between symptoms and quality of life in patients with schizophrenia: a pooled analysis of changes over time. Schizophr Res. 2011; 133(1-3):17-21. DOI: 10.1016/j.schres.2011.09.021. View

Bech P, Fava M, Trivedi M, Wisniewski S, Rush A . Outcomes on the pharmacopsychometric triangle in bupropion-SR vs. buspirone augmentation of citalopram in the STAR*D trial. Acta Psychiatr Scand. 2011; 125(4):342-8. DOI: 10.1111/j.1600-0447.2011.01791.x. View

10.

Kraemer H, Frank E . Evaluation of comparative treatment trials: assessing clinical benefits and risks for patients, rather than statistical effects on measures. JAMA. 2010; 304(6):683-4. DOI: 10.1001/jama.2010.1133. View

11.

Porcelli S, Kasper S, Zohar J, Souery D, Montgomery S, Ferentinos P . Social dysfunction in mood disorders and schizophrenia: Clinical modulators in four independent samples. Prog Neuropsychopharmacol Biol Psychiatry. 2019; 99:109835. DOI: 10.1016/j.pnpbp.2019.109835. View

12.

Baandrup L, Rasmussen J, Mainz J, Videbech P, Kristensen S . Patient-reported outcome measures in mental health clinical research: a descriptive review in comparison with clinician-rated outcome measures. Int J Qual Health Care. 2021; 34(Supplement_1):ii70-ii97. DOI: 10.1093/intqhc/mzab001. View

13.

Eack S, Newhill C . Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007; 33(5):1225-37. PMC: 2632363. DOI: 10.1093/schbul/sbl071. View

14.

Schouby Bock M, van Achter O, Dines D, Speed M, Correll C, Mors O . Clinical validation of the self-reported Glasgow Antipsychotic Side-effect Scale using the clinician-rated UKU side-effect scale as gold standard reference. J Psychopharmacol. 2020; 34(8):820-828. DOI: 10.1177/0269881120916122. View

15.

Topp C, Ostergaard S, Sondergaard S, Bech P . The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015; 84(3):167-76. DOI: 10.1159/000376585. View

16.

Engh J, Friis S, Birkenaes A, Jonsdottir H, Klungsoyr O, Ringen P . Delusions are associated with poor cognitive insight in schizophrenia. Schizophr Bull. 2009; 36(4):830-5. PMC: 2894586. DOI: 10.1093/schbul/sbn193. View

17.

Huppert J, Weiss K, Lim R, Pratt S, Smith T . Quality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res. 2001; 51(2-3):171-80. DOI: 10.1016/s0920-9964(99)00151-6. View

18.

Velligan D, Sajatovic M, Hatch A, Kramata P, Docherty J . Why do psychiatric patients stop antipsychotic medication? A systematic review of reasons for nonadherence to medication in patients with serious mental illness. Patient Prefer Adherence. 2017; 11:449-468. PMC: 5344423. DOI: 10.2147/PPA.S124658. View

19.

Rocca P, Bellino S, Calvarese P, Marchiaro L, Patria L, Rasetti R . Depressive and negative symptoms in schizophrenia: different effects on clinical features. Compr Psychiatry. 2005; 46(4):304-10. DOI: 10.1016/j.comppsych.2004.09.001. View

20.

Huppert J, Smith T . Longitudinal analysis of subjective quality of life in schizophrenia: anxiety as the best symptom predictor. J Nerv Ment Dis. 2001; 189(10):669-75. DOI: 10.1097/00005053-200110000-00003. View