The Association of Antipsychotic Treatment and Side Effects With Societal Recovery and Happiness: A Naturalistic Cohort Study of People in Long-term Care for a Psychotic Disorder.
Stijn Crutzen, Shiral Gangadin, Ken Ho Hua, Ellen Visser, Frederike Jörg, Gerdina Hendrika Maria Pijnenborg, Lisette van der Meer, Wim Veling, Stynke Castelein
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Abstract
Background: Antipsychotics are used to manage symptoms and reduce the risk of relapse. However, the antipsychotic side effects are associated with a lower quality of life and are seen as major barriers to achieving societal recovery by antipsychotic users. In this study, we investigate the association of side effects, antipsychotic dose, and antipsychotic polypharmacy with societal recovery and happiness.
Study design: Data were used from a large, naturalistic, longitudinal cohort of people using an antipsychotic in long-term care (Pharmacotherapy Monitoring and Outcome Survey [PHAMOUS], 2013-2021). The association between subjective antipsychotic side-effect burden (measured with the Subjective Response to Antipsychotics questionnaire), antipsychotic dose, and antipsychotic polypharmacy with societal recovery and happiness was investigated using mixed-effect linear regression models. In an exploratory analysis, the associations between individual side effects with societal recovery and happiness were assessed.
Study results: Data from 5971 observations nested in 2490 participants were used. The subjective antipsychotic side-effect burden, total antipsychotic dose, and antipsychotic polypharmacy were significantly negatively associated with societal recovery. Subjective antipsychotic side-effect burden and total antipsychotic dose were significantly negatively associated with happiness, but antipsychotic polypharmacy was not. Cognitive, mood, and physical anticholinergic side effects were most strongly negatively associated with societal recovery. Mood-, sedation-, cognitive-, and sexual-related side effects were most strongly negatively associated with happiness.
Conclusions: These results show that side effects and a higher dose of antipsychotic medication are negatively associated with societal functioning and happiness. Future research should focus on whether dose reduction is beneficial for societal recovery and happiness in the long-term.
期刊介绍：
Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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