ABSTRACT
INTRODUCTION: To support clinical practice as well as clinical research, self-rating scales have been developed to evaluate the effects and side effects of antipsychotic treatment. The aim of this study is to compare the psychometric properties and other characteristics of frequently used self-rating scales, and also to study their relationship to subjective quality of life. METHOD: Four self-rating scales designed to evaluate the treatment effects of antipsychotics were identified through a MEDLINE and cross-references search: The Drug Attitude Inventory (DAI-10), The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), Subjective Well-being to Neuroleptics (SWN) and the recently developed Subjects' Reaction to Antipsychotics questionnaire (SRA). Three hundred and twenty patients with schizophrenia who were treated with antipsychotics completed these questionnaires, including a quality of life instrument, the WHO-QoLBREF. RESULTS: The self-rating scales differed in scope, number of items and subscales (total and subscale scores), but showed an acceptable internal reliability (Cronbach's alphas varying between .64 and .93) except for the DAI-10 (.52), and all were easy to complete (in less than 20 min). They did not strongly correlate with each other, except for the LUNSERS and SRA undesired experiences subscale (r=.68, p<.01). All correlations with quality of life were statistically significant, but were especially so for the SWN (.78, p<.01). CONCLUSION: Clinicians interested in the experience of the effects and side effects of antipsychotic medication in their patients are well advised to carefully consider the pros and cons of the available rating scales. They differ with respect to their internal reliability, concurrent and conceptual validity, as well as with respect to desired and undesired effects, aspects of quality of life, and attribution to medication. The choice also depends on its intended use, whether in clinical practice or in research or in both.
Subject(s)
Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Psychiatric Status Rating Scales , Psychometrics/methods , Schizophrenia/drug therapy , Schizophrenic Psychology , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Personal Satisfaction , Quality of Life , Reproducibility of Results , Retrospective Studies , Statistics, Nonparametric , Surveys and Questionnaires , Treatment OutcomeABSTRACT
The present study reports on the development of a new self-administered instrument to assess patients' responses to antipsychotic medication. The Subjects' Response to Antipsychotics (SRA) Questionnaire is a 74-item instrument with eight scales (Recovery, Weight Gain, Sexual Anhedonia, Sedation, Affective Flattening, Extrapyramidal Side-Effects, Diminished Sociability and Increased Sleep), and a total adverse responses score including additional items. Psychometric aspects were examined in a study of 320 inpatients and outpatients showing good internal consistency, reproducibility and external validity. Concordance with other instruments claiming to measure the subjective response is low, suggesting that the instruments measure different concepts. The SRA Questionnaire appears to be a reliable and efficient way of measuring patients' subjective responses to antipsychotic medication.
Subject(s)
Antipsychotic Agents/therapeutic use , Attitude to Health , Psychotic Disorders/drug therapy , Surveys and Questionnaires , Adult , Drug Monitoring , Female , Humans , Male , Middle Aged , Psychometrics , Reproducibility of ResultsABSTRACT
BACKGROUND: This study examined the spectrum of subjective experiences which patients attribute to the use of antipsychotic medication. METHODS: We collected interview data and answers to structured questions based on a comprehensive checklist in 77 patients using various types of classical or atypical antipsychotic drugs. RESULTS: The responses of the patients could be categorized into psychological and somatic domains. The psychological domain could be subdivided into emotional, cognitive and sociability domains. The somatic set could be subdivided into activation and physiological domains. CONCLUSIONS: Our data reveal that the same effects may be experienced in either a positive or a negative way by different patients. We conclude that existing scales for measuring subjective effects of antipsychotic medication are incomplete.
