Relationship of Long Acting Injectable Antipsychotics with Caregiver Burden, Quality of Life, Symptom Severity and Treatment Discontinuation in Schizophrenia.

Abstract

Objective: Regarding the patients using long acting injectable (LAI) antipsychotic treatment; we aimed to investigate the effect of attitude towards drugs, antipsychotic type and side effects on quality of life, caregiver burden and continuation of treatment.

Method: Our study sample consisted of 110 patients in the age range of 18-65 using LAI antipsychotics for at least 12 weeks with the diagnosis of schizophrenia according to DSM-5 criteria. Sociodemographic and Clinical Data Form, Drug Attitude Inventory 10 (DAI-10), Positive and Negative Syndrome Scale (PANSS), UKU Side Effect Rating Scale, Quality of Life for Schizophrenia Scale were used for evaluation of patients. Sociodemographic Data Form, Zarit Caregiver Burden Scale (ZCBS) were used for the caregivers.

Results: It is observed that the patients with positive attitude against the treatment had longer antipsychotic treatment duration (13.7+9.1 years) compared to patients with negative attitude (7.7 + 6.6 years) (p<0.001). PANSS total scores of patients who were considering about treatment discontinuation (44.0+14.3) were higher than the other patients (38.6+9.0) (p=0.03) and DAI-10 scores of patients who were considering about treatment discontinuation were lower (1.4+4.9; 5.2+3.4; p<0.001). Duration of illness were also shorter (10.3+9.3 year) for the patients who were considering about treatment discontinuation than the other group (15.7 + 9.0 year) (p=0.01). There was no significant difference in caregiver burden, side effects, quality of life and reasons for treatment discontinuation between typical and atypical antipsychotics. According to the regression analysis results, PANSS score (β=0.553, p<0.001) and male gender (β= 0.225, p=0.003) were positive predictors of ZCBS scores.

Conclusion: It is observed that the attitude towards drugs and psychotic symptom severity were the most important factors for treatment discontinuation in patients with schizophrenia using LAI antipsychotics. Atypical and typical antipsychotics were not different with respect to quality of life and caregiver burden for the patients on regular treatment with LAI antipsychotics.