Subjective well-being in patients with schizophrenia treated with atypical antipsychotics: The impact of psychopathology and adverse drug effects

Objective: According to a conceptual clinical model of subjective well-being in schizophrenia, subjective well-being is viewed as the subject's perception of the outcome of an interaction between psychotic symptom severity and adverse drug effects. However, data are lacking for patients receiving atypical antipsychotics. The purpose of the present study was to evaluate the impact of psychopathology and adverse drug effects on subjective well-being in schizophrenic patients receiving atypical antipsychotics. Methods: One hundred and thirteen outpatients with schizophrenia receiving atypical antipsychotics were evaluated. Subjective well-being was assessed using the Subjective Well-being under Neuroleptics Scale (SWN). The patients' psychopathology and adverse drug effects were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), respectively. Correlation analysis and multiple regression analysis were performed. Results: The SWN score had significant negative correlations with the PANSS depression/anxiety factor score and the LUNSERS scores. Multiple regression analysis revealed that depression/anxiety and akathisia contributed significantly to the SWN score. The best-fit regression model showed that these variables accounted for 29% of the total variance. Conclusion: The results of our study suggest that depressive/anxiety symptoms and akathisia contribute significantly to subjective well-being, indicating the necessity to develop strategies to control these variables effectively. These results also suggest that akathisia continues to be a major adverse effect associated with low subjective well-being in patients receiving atypical antipsychotics. Further studies are required to investigate the multidimensional predictors of subjective well-being in schizophrenia and to determine their relative contributions.