Improvement of schizophrenic patients' subjective well-being under atypical antipsychotic drugs

Recent research indicates that subjective well-being is a major determinant of medication compliance in schizophrenia. However, it is yet unresolved w hether atypical neuroleptics differ regarding subjective side-effects. A se lf-report instrument has been constructed to evaluate 'subjective well-bein g under neuroleptics' (SWN). The primary aims of the present study were to develop a short form of the SWN and to investigate the extent to which the atypical antipsychotic improves the patient's subjective well-being. The short form of the SWN was constructed following an item analysis based on data from 212 schizophrenic patients medicated with either typical or at ypical antipsychotics. The short form of the SWN showed sufficient internal consistency and good construct validity. The SWN was only moderately corre lated with positive and negative syndrome scale (PANSS) scores or changes i n psychopathology (r = -0.20 to -0.37). SWN-ratings in patients receiving o lanzapine were superior compared to those of patients medicated with either clozapine or risperidone on three of five domains of well-being. Clozapine reduced global psychiatric symptoms significantly more than risperidone. I t is concluded that the assessment of subjective well-being under antipsych otic treatment provides an independent outcome measure which is relevant to compliance. (C) 2001 Elsevier Science B.V. All rights reserved.