Response and remission of subjective well-being in patients suffering from schizophrenia spectrum disorders - 01/05/10

Doi : 10.1016/j.eurpsy.2009.11.005

R. Schennach-Wolff ^a,^⁎ , F. Seemüller ^a, M. Obermeier ^a, T. Messer ^b, G. Laux ^c, H. Pfeiffer ^d, D. Naber ^e, L.G. Schmidt ^f, W. Gaebel ^g, J. Klosterkötter ^h, I. Heuser ⁱ, W. Maier ^j, M.R. Lemke ^k, E. Rüther ^l, G. Buchkremer ^m, M. Gastpar ⁿ, M. Jäger ^a, H.J. Möller ^a, M. Riedel ^a,^o
^a Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstraße 7, 80336 Munich, Germany
^b Psychiatric Clinic, District Hospital Augsburg, Augsburg, Germany
^c Psychiatric Clinic, District Hospital Gabersee, Wasserburg/Inn, Germany
^d Psychiatric Clinic, District Hospital Haar, Munich, Germany
^e Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany
^f Department of Psychiatry and Psychotherapy, University of Mainz, Mainz, Germany
^g Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
^h Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
ⁱ Department of Psychiatry and Psychotherapy, Charite Berlin, Campus Benjamin Franklin, Berlin, Germany
^j Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
^k Department of Psychiatry and Psychotherapy, Alsterdorf Hospital, Hamburg, Germany
^l Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
^m Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
ⁿ Department of Psychiatry and Psychotherapy, University of Essen, Essen, Germany
^o Psychiatric Clinic, Vinzenz-von-Paul-Hospital, Rottweil, Germany

Corresponding author. Tel.: +49 89 5160 5511; fax: +49 89 5160 5728.

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Abstract

Background

Purpose of this study was to assess subjective well-being in schizophrenia inpatients and to find variables predictive for response and remission of subjective well-being.

Method

The subjective well-being under neuroleptic treatment scale (SWN-K) was used in 232 schizophrenia patients within a naturalistic multicenter trial. Early response was defined as a SWN-K total score improvement of 20% and by at least 10 points within the first 2 treatment weeks, response as an improvement in SWN-K total score of at least 20% and by at least 10 points from admission to discharge and remission in subjective well-being as a total score of more or equal to 80 points at discharge. Logistic regression and CART analyses were used to determine valid predictors of subjective well-being outcome.

Results

Twenty-nine percent of the patients were detected to be SWN-K early responders, 40% fulfilled criteria for response in subjective well-being and 66% fulfilled criteria for remission concerning subjective well-being. Among the investigated predictors, SWN-K early improvement and the educational status were significantly associated with SWN-K response. The SWN-K total score at baseline showed a significant negative predictive value for response. Baseline SWN-K total score, PANSS global subscore, and side effects as well as the educational status were found to be significantly predictive for remission.

Conclusions

Depressive symptoms should be radically treated and side effects closely monitored to improve the patient’s subjective well-being. The important influence of subjective well-being on overall treatment outcome could be underlined.

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Keywords : Schizophrenia and psychosis, Quality of life, Response, Remission, Predictor variables