Psychiatric Quarterly

, Volume 85, Issue 3, pp 357–367 | Cite as

Quality of Life in Patients with Schizophrenia: The Impact of Socio-economic Factors and Adverse Effects of Atypical Antipsychotics Drugs

  • Aurigena Antunes de Araújo
  • Diego de Araújo Dantas
  • Gemma Galgani do Nascimento
  • Susana Barbosa Ribeiro
  • Katarina Melo Chaves
  • Vanessa de Lima Silva
  • Raimundo Fernandes de AraújoJr.
  • Dyego Leandro Bezerra de Souza
  • Caroline Addison Carvalho Xavier de Medeiros
Original Paper

Abstract

This cross-sectional study compared the effects of treatment with atypical antipsychotic drugs on quality of life (QoL) and side effects in 218 patients with schizophrenia attending the ambulatory services of psychiatric in Rio Grande do Norte, Brazil. Socio-economic variables were compared. The five-dimension EuroQoL (EQ-5D) was used to evaluate QoL, and side effects were assessed using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale and the Simpson–Angus Scale. Data were analysed using the χ2 test and Student’s t test, with a significance level of 5 %. Average monthly household incomes in the medication groups were 1.1–2.1 minimum wages ($339–$678). UKU Scale scores showed significant differences in side effects, mainly, clozapine, quetiapine and ziprasidone (p < 0.05). EQ-5D scores showed that all drugs except olanzapine significantly impacted mobility (p < 0.05), and proportions of individuals reporting problems in other dimensions were high: 63.6 % of clozapine users reported mobility problems, 63.7 and 56.3 % of clozapine and ziprasidone users, respectively, had difficulties with usual activities, 68.8 and 54.5 % of ziprasidone and clozapine users, respectively, experienced pain and/or discomfort, and 72.8 % of clozapine users reported anxiety and/or depression. Psychiatric, neurological, and autonomous adverse effects, as well as other side effects, were prevalent in users of atypical antipsychotic drugs, especially clozapine and ziprasidone. Olanzapine had the least side effects. QoL was impacted by side effects and economic conditions in all groups. Thus, the effects of these antipsychotic agents appear to have been masked by aggravating social and economic situations.

Keywords

Schizophrenia Atypical antipsychotic Quality of life 

References

  1. 1.
    Switaj P, Anczewska M, Chrostek A, Sabariego C, Cieza A, Bickenbach J, et al.: Disability and schizophrenia: A systematic review of experienced psychosocial difficulties. BMC Psychiatry 12:193, 2012.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Adelufosi AO, Ogunwale A, Abayomi O, Mosanya JT: Socio-demographic and clinical correlates of subjective quality of life among Nigerian outpatients with schizophrenia. Psychiatry Research 209(3):320–325, 2013 (Epub 5 Mar 2013).Google Scholar
  3. 3.
    Xiang YT, Weng YZ, Leung CM, Tang WK, Ungvari GS: Subjective quality of life in outpatients with schizophrenia in Hong Kong and Beijing: Relationship to socio-demographic and clinical factors. Quality of Life Research 17(1):27–36, 2008 (Epub 24 Nov 2007).PubMedCrossRefGoogle Scholar
  4. 4.
    Xiang YT, Wang CY, Wang Y, Chiu HF, Zhao JP, Chen Q, et al.: Socio-demographic and clinical determinants of quality of life in Chinese patients with schizophrenia: A prospective study. Quality of Life Research 19(3):317–322, 2010 (Epub 6 Feb 2010).PubMedCrossRefGoogle Scholar
  5. 5.
    Wetherell JL, Palmer BW, Thorp SR, Patterson TL, Golshan S, Jeste DV: Anxiety symptoms and quality of life in middle-aged and older outpatients with schizophrenia and schizoaffective disorder. The Journal of Clinical Psychiatry 64(12):1476–1482, 2003.PubMedCrossRefGoogle Scholar
  6. 6.
    Hsiao CY, Hsieh MH, Tseng CJ, Chien SH, Chang CC: Quality of life of individuals with schizophrenia living in the community: Relationship to socio-demographic, clinical and psychosocial characteristics. Journal of Clinical Nursing 21(15–16):2367–2376, 2012 (Epub 14 June 2012).PubMedCrossRefGoogle Scholar
  7. 7.
    Caron J, Mercier C, Diaz P, Martin A: Socio-demographic and clinical predictors of quality of life in patients with schizophrenia or schizo-affective disorder. Psychiatry Research 137(3):203–213, 2005 (Epub 22 Nov 2005).PubMedCrossRefGoogle Scholar
  8. 8.
    Rocca P, Giugiario M, Montemagni C, Rigazzi C, Rocca G, Bogetto F: Quality of life and psychopathology during the course of schizophrenia. Comprehensive Psychiatry 50(6):542–548, 2009.PubMedCrossRefGoogle Scholar
  9. 9.
    Chugh PK, Rehan HS, Unni KE, Sah RK: Predictive value of symptoms for quality of life in first-episode schizophrenia. Nordic Journal of Psychiatry 67(3):153–158, 2012.Google Scholar
  10. 10.
    Browne S, Roe M, Lane A, Gervin M, Morris M, Kinsella A, et al.: Quality of life in schizophrenia: Relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiatrica Scandinavica 94(2):118–124, 1996 (Epub 1 Aug 1996).PubMedCrossRefGoogle Scholar
  11. 11.
    Kemmler G, Meise U, Tasser A, Liensberger D, Schifferle I, Braitenberg M, et al.: Subjective quality of life of schizophrenic patients. Effect of treatment setting, psychopathology and extrapyramidal motor drug effects [Subjektive Lebensqualitat schizophren Erkrankter. Einfluss von Behandlungssetting, Psychopathologie und extrapyramidalmotorischen Medikamentennebenwirkungen]. Psychiatrische Praxis 26(1):9–15, 1999.Google Scholar
  12. 12.
    Loga-Zec S, Loga S: Antipsychotics and the quality of life of schizophrenic patients. Psychiatria Danubina 22(4):495–497, 2010 (Epub 21 Dec 2010).PubMedGoogle Scholar
  13. 13.
    Zouari L, Thabet JB, Elloumi Z, Elleuch M, Zouari N, Maalej M: Quality of life in patients with schizophrenia: A study of 100 cases [Qualite de vie des malades atteints de schizophrenie: etude de 100 cas]. L’Encephale 38(2):111–117, 2012 (Epub 21 April 2012).Google Scholar
  14. 14.
    Fujimaki K, Takahashi T, Morinobu S: Association of typical versus atypical antipsychotics with symptoms and quality of life in schizophrenia. PloS One 7(5):e37087, 2012.PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Fang M, Li L, Zhao J, Chen H, Ye M, Guo X, et al.: Effect of antipsychotic drugs on life quality of schizophrenic patients: One year follow-up study. Zhong nan da xue xue bao Yi xue ban = Journal of Central South University Medical Sciences 34(9):850–855, 2009.Google Scholar
  16. 16.
    Chaves KM, Serrano-Blanco A, Ribeiro SB, Soares LA, Guerra GC, do Socorro Costa Feitosa Alves M, et al.: Quality of life and adverse effects of olanzapine versus risperidone therapy in patients with schizophrenia. The Psychiatric Quarterly 84(1):125–135, 2013 (Epub 19 July 2012).PubMedCrossRefGoogle Scholar
  17. 17.
    Cascade E, Kalali AH, Mehra S, Meyer JM: Real-world data on atypical antipsychotic medication side effects. Psychiatry (Edgmont) 7(7):9–12, 2010 (Epub 2 Sep 2010).Google Scholar
  18. 18.
    Rosa MA, Marcolin MA, Elkis H: Evaluation of the factors interfering with drug treatment compliance among Brazilian patients with schizophrenia. The Revista Brasileira de Psiquiatria 27(3):178–184, 2005 (Epub 15 Oct 2005).CrossRefGoogle Scholar
  19. 19.
    Rocha FL, Hara C: Benefits of combining aripiprazole to clozapine: Three case reports. Progress in Neuro-psychopharmacology and Biological Psychiatry 30(6):1167–1169, 2006 (Epub 2 May 2006).PubMedCrossRefGoogle Scholar
  20. 20.
    Viana Bde M, Prais HA, Camargos ST, Cardoso FE: Ziprasidone-related oculogyric crisis in an adult. Clinical Neurology and Neurosurgery 111(10):883–885, 2009 (Epub 1 Sep 2009).PubMedCrossRefGoogle Scholar
  21. 21.
    American PA: Manual Diagnóstico e Estatístico de Transtornos Mentais—DSM-IV-TR-TM. Porto Alegre, ArtMed, 2003.Google Scholar
  22. 22.
    Human D: Declaration of Helsinki. Lancet 357(9251):236, 2001 (Epub 24 Feb 2001).PubMedCrossRefGoogle Scholar
  23. 23.
    Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K: The UKU side effect rating scale. A new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatrica Scandinavica Supplementum 334:1–100, 1987 (Epub 1 Jan 1987).PubMedCrossRefGoogle Scholar
  24. 24.
    Janno S, Holi MM, Tuisku K, Wahlbeck K: Validity of Simpson–Angus Scale (SAS) in a naturalistic schizophrenia population. BMC Neurology 5(1):5, 2005 (Epub 19 March 2005).PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Louza Neto MR: Escalas de avaliacao de efeitos colaterais de antipsicoticos [Rating scales of side effects of antipsychotics]. Revista de Psiquiatria Clínica (Säo Paulo). 25(6):357–367, 1998.Google Scholar
  26. 26.
    Pinto EB, Maso I, Vilela RNR, Santos LC, Oliveira-Filho J: Validation of the EuroQoL quality of life questionnaire on stroke victims. Arquivos de Neuro-psiquiatria 69:320–323, 2011.PubMedCrossRefGoogle Scholar
  27. 27.
    Golubovic B, Misic-Pavkov G, Gajic Z, Ivanovic-Kovacevic S: Evaluation of quality of life for patients with schizophrenic and schizoaffective disorders related to the use of antipsychotic therapy. Medicinski Arhiv 64(1):37–40, 2010 (Epub 29 Apr 2010).Google Scholar
  28. 28.
    Awad AG, Voruganti LN: Impact of atypical antipsychotics on quality of life in patients with schizophrenia. CNS Drugs 18(13):877–893, 2004 (Epub 04 Nov 2004).Google Scholar
  29. 29.
    Ritsner M, Perelroyzen G, Ilan H, Gibel A: Subjective response to antipsychotics of schizophrenia patients treated in routine clinical practice: A naturalistic comparative study. Journal of Clinical Psychopharmacology 24(3):245–254, 2004 (Epub 01 May 2004).Google Scholar
  30. 30.
    Valadares FC: Desafios políticos da reforma psiquiátrica brasileira. Ciencia & saude coletiva 18:573–574, 2013.CrossRefGoogle Scholar
  31. 31.
    Costa JAS, Andrade KVFd: Perfil dos usuários incluídos no protocolo de esquizofrenia em um programa de medicamentos do componente especializado da assistência farmacêutica. Rev baiana saúde pública 35(2):446–456, 2011.Google Scholar
  32. 32.
    Saúde Md. PORTARIA Nº 364, DE 9 DE ABRIL DE 2013: Aprova o Protocolo Clínico e Diretrizes Terapêuticas - Esquizofrenia. In: Saúde SdAà (Ed) Brasília, 2013.Google Scholar
  33. 33.
    Liu-Seifert H, Osuntokun OO, Feldman PD: Factors associated with adherence to treatment with olanzapine and other atypical antipsychotic medications in patients with schizophrenia. Comprehensive Psychiatry 53(1):107–115, 2012 (Epub 12 Feb 2011).Google Scholar
  34. 34.
    Joffe G, Sintonen H, Appelberg B: Shift from first generation antipsychotics to olanzapine may improve health-related quality of life of stable but residually symptomatic schizophrenic outpatients: A prospective, randomized study. International Journal of Technology Assessment in Health Care 24(4):399–402, 2008.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Aurigena Antunes de Araújo
    • 1
    • 4
    • 7
  • Diego de Araújo Dantas
    • 2
  • Gemma Galgani do Nascimento
    • 3
  • Susana Barbosa Ribeiro
    • 4
  • Katarina Melo Chaves
    • 4
  • Vanessa de Lima Silva
    • 5
  • Raimundo Fernandes de AraújoJr.
    • 6
  • Dyego Leandro Bezerra de Souza
    • 7
  • Caroline Addison Carvalho Xavier de Medeiros
    • 1
    • 8
  1. 1.Department of Biophysical and PharmacologyUniversidade Federal do Rio Grande do Norte (UFRN)NatalBrazil
  2. 2.Department of the Post Graduation Program in Health and Society/UERNUERNNatalBrazil
  3. 3.Department of NursingUERNMossoróBrazil
  4. 4.Post Graduation Program of Pharmaceutical ScienceUniversidade Federal do Rio Grande do Norte (UFRN)NatalBrazil
  5. 5.Department of Pharmaceutical ScienceUFRNNatalBrazil
  6. 6.Department of Morphology, Post Graduation Program in Functional and Structural Biology/Post Graduation Program Health ScienceUFRNNatalBrazil
  7. 7.Post Graduation Program Public HealthUFRNNatalBrazil
  8. 8.Post Graduation Program in Health and Society (UERN)MossoróBrazil

Personalised recommendations