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Published in: BMC Psychiatry 1/2021

Open Access 01-12-2021 | Schizophrenia | Research article

Associations between symptom severity and well-being among Thai patients with schizophrenia: a cross-sectional analytical study

Authors: Teerapat Teetharatkul, Arnont Vitayanont, Tippawan Liabsuetrakul, Warut Aunjitsakul

Published in: BMC Psychiatry | Issue 1/2021

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Abstract

Background

Severity of symptoms in patients with schizophrenia is a determinant of patient’s well-being, but evidence in low- and middle-income countries is limited. We aimed to measure the symptom severity using objective measurements, the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity scale (CGI-S), and their associations with well-being in patients with schizophrenia.

Methods

Patients with schizophrenia aged ≥18 years, without active psychosis including no history of hospitalization within the last 6 months, were included. Symptom severity was measured by the clinicians using BPRS and CGI-S. The patients’ well-being was assessed by self-report using the Subjective Well-being under Neuroleptic treatment scale (SWN) as continuous and binary outcomes (categorized into adequate or poor well-being). Correlations between symptom severity (BPRS and CGI-S scores) and well-being (SWN score) were analyzed using Pearson’s correlation. Association between well-being status and BPRS was analyzed using multivariate logistic regression.

Results

Of 150 patients, BPRS and CGI-S were inversely correlated with SWN score (r = − 0.47; p < 0.001 and − 0.21; p < 0.01, respectively). BPRS Affect domain had the highest correlation with SWN (r = − 0.51, p < 0.001). In multivariate logistic regression, BPRS score and being unemployed were associated with poor well-being status (adjusted OR 1.08; 95%CI 1.02–1.14; p = 0.006, and 4.01; 95%CI 1.38–11.7; p = 0.011, respectively).

Conclusion

Inverse relationships between symptom severity and well-being score were found. Higher BPRS Affect domain was significantly associated with lower patients’ well-being. The use of BPRS tool into routine clinical practice could serve as an adjunct to physician’s clinical evaluation of patients’ symptoms and may help improve patient’s well-being. Further research on negative symptoms associated with well-being is required.
Literature
1.
go back to reference Redelmeier DA, Ferris LE, Tu JV, Hux JE, Schull MJ. Problems for clinical judgement: introducing cognitive psychology as one more basic science. CMAJ. 2001;164(3):358–60.PubMedPubMedCentral Redelmeier DA, Ferris LE, Tu JV, Hux JE, Schull MJ. Problems for clinical judgement: introducing cognitive psychology as one more basic science. CMAJ. 2001;164(3):358–60.PubMedPubMedCentral
2.
go back to reference Jaaskelainen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull. 2013;39(6):1296–306.CrossRef Jaaskelainen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull. 2013;39(6):1296–306.CrossRef
3.
go back to reference Andreasen NC. The lifetime trajectory of schizophrenia and the concept of neurodevelopment. Dialogues Clin Neurosci. 2010;12(3):409–15.CrossRef Andreasen NC. The lifetime trajectory of schizophrenia and the concept of neurodevelopment. Dialogues Clin Neurosci. 2010;12(3):409–15.CrossRef
4.
go back to reference Palmer BW, Dawes SE, Heaton RK. What do we know about neuropsychological aspects of schizophrenia? Neuropsychol Rev. 2009;19(3):365–84.CrossRef Palmer BW, Dawes SE, Heaton RK. What do we know about neuropsychological aspects of schizophrenia? Neuropsychol Rev. 2009;19(3):365–84.CrossRef
5.
go back to reference Bowie CR, Depp C, McGrath JA, Wolyniec P, Mausbach BT, Thornquist MH, et al. Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. Am J Psychiatry. 2010;167(9):1116–24.CrossRef Bowie CR, Depp C, McGrath JA, Wolyniec P, Mausbach BT, Thornquist MH, et al. Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. Am J Psychiatry. 2010;167(9):1116–24.CrossRef
6.
go back to reference Hennekens CH, Hennekens AR, Hollar D, Casey DE. Schizophrenia and increased risks of cardiovascular disease. Am Heart J. 2005;150(6):1115–21.CrossRef Hennekens CH, Hennekens AR, Hollar D, Casey DE. Schizophrenia and increased risks of cardiovascular disease. Am Heart J. 2005;150(6):1115–21.CrossRef
7.
go back to reference Auquier P, Lancon C, Rouillon F, Lader M, Holmes C. Mortality in schizophrenia. Pharmacoepidemiol Drug Saf. 2006;15(12):873–9.CrossRef Auquier P, Lancon C, Rouillon F, Lader M, Holmes C. Mortality in schizophrenia. Pharmacoepidemiol Drug Saf. 2006;15(12):873–9.CrossRef
8.
go back to reference Buckley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities and schizophrenia. Schizophr Bull. 2009;35(2):383–402.CrossRef Buckley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities and schizophrenia. Schizophr Bull. 2009;35(2):383–402.CrossRef
9.
go back to reference Lambert M, Schimmelmann BG, Schacht A, Karow A, Wagner T, Wehmeier PM, et al. Long-term patterns of subjective wellbeing in schizophrenia: cluster, predictors of cluster affiliation, and their relation to recovery criteria in 2842 patients followed over 3 years. Schizophr Res. 2009;107(2–3):165–72.CrossRef Lambert M, Schimmelmann BG, Schacht A, Karow A, Wagner T, Wehmeier PM, et al. Long-term patterns of subjective wellbeing in schizophrenia: cluster, predictors of cluster affiliation, and their relation to recovery criteria in 2842 patients followed over 3 years. Schizophr Res. 2009;107(2–3):165–72.CrossRef
10.
go back to reference Hofer A, Kemmler G, Eder U, Edlinger M, Hummer M, Fleischhacker WW. Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry. 2004;65(7):932–9.CrossRef Hofer A, Kemmler G, Eder U, Edlinger M, Hummer M, Fleischhacker WW. Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry. 2004;65(7):932–9.CrossRef
11.
go back to reference Aunjitsakul W, Pitanupong J. Schizophrenias’ quality of life and emotional intelligence in Songklanagarind hospital. J Health Sci Med Res. 2018;36(1):61–71. Aunjitsakul W, Pitanupong J. Schizophrenias’ quality of life and emotional intelligence in Songklanagarind hospital. J Health Sci Med Res. 2018;36(1):61–71.
12.
go back to reference Aunjitsakul W, Teetharatkul T, Vitayanont A, Liabsuetrakul T. Correlations between self-reported and psychiatrist assessments of well-being among patients with schizophrenia. Gen Hosp Psychiatry. 2019;56:52–3.CrossRef Aunjitsakul W, Teetharatkul T, Vitayanont A, Liabsuetrakul T. Correlations between self-reported and psychiatrist assessments of well-being among patients with schizophrenia. Gen Hosp Psychiatry. 2019;56:52–3.CrossRef
13.
go back to reference Yeon-Woo Lee J-HK, Ann J-H, Cho S-E, Lee J, Kim M-J, Cho S-J, et al. Subjective well-being in patients with schizophrenia treated with atypical antipsychotics: the impact of psychopathology and adverse drug effects. Clin Psychopharmacol Neurosci. 2010;8(3):149–55. Yeon-Woo Lee J-HK, Ann J-H, Cho S-E, Lee J, Kim M-J, Cho S-J, et al. Subjective well-being in patients with schizophrenia treated with atypical antipsychotics: the impact of psychopathology and adverse drug effects. Clin Psychopharmacol Neurosci. 2010;8(3):149–55.
14.
go back to reference Vothknecht S, Meijer C, Zwinderman A, Kikkert M, Dekker J, van Beveren N, et al. Psychometric evaluation of the subjective well-being under neuroleptic treatment scale (SWN) in patients with schizophrenia, their relatives and controls. Psychiatry Res. 2013;206(1):62–7.CrossRef Vothknecht S, Meijer C, Zwinderman A, Kikkert M, Dekker J, van Beveren N, et al. Psychometric evaluation of the subjective well-being under neuroleptic treatment scale (SWN) in patients with schizophrenia, their relatives and controls. Psychiatry Res. 2013;206(1):62–7.CrossRef
15.
go back to reference Naber D, Moritz S, Lambert M, Pajonk FG, Holzbach R, Mass R, et al. Improvement of schizophrenic patients' subjective well-being under atypical antipsychotic drugs. Schizophr Res. 2001;50(1–2):79–88.CrossRef Naber D, Moritz S, Lambert M, Pajonk FG, Holzbach R, Mass R, et al. Improvement of schizophrenic patients' subjective well-being under atypical antipsychotic drugs. Schizophr Res. 2001;50(1–2):79–88.CrossRef
16.
go back to reference Karow A, Naber D, Lambert M, Moritz S, Initiative E. Remission as perceived by people with schizophrenia, family members and psychiatrists. Eur Psychiatry. 2012;27(6):426–31.CrossRef Karow A, Naber D, Lambert M, Moritz S, Initiative E. Remission as perceived by people with schizophrenia, family members and psychiatrists. Eur Psychiatry. 2012;27(6):426–31.CrossRef
17.
go back to reference Leucht S, Samara M, Heres S, Davis JM. Dose equivalents for antipsychotic drugs: the DDD method. Schizophr Bull. 2016;42(Suppl 1):S90–4.CrossRef Leucht S, Samara M, Heres S, Davis JM. Dose equivalents for antipsychotic drugs: the DDD method. Schizophr Bull. 2016;42(Suppl 1):S90–4.CrossRef
18.
go back to reference Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep. 1962;10:799–812.CrossRef Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep. 1962;10:799–812.CrossRef
19.
go back to reference Shafer A. Meta-analysis of the brief psychiatric rating scale factor structure. Psychol Assess. 2005;17(3):324–35.CrossRef Shafer A. Meta-analysis of the brief psychiatric rating scale factor structure. Psychol Assess. 2005;17(3):324–35.CrossRef
20.
go back to reference Andersen J, Larsen JK, Schultz V, Nielsen BM, Korner A, Behnke K, et al. The brief psychiatric rating scale. Dimension of schizophrenia--reliability and construct validity. Psychopathology. 1989;22(2–3):168–76.CrossRef Andersen J, Larsen JK, Schultz V, Nielsen BM, Korner A, Behnke K, et al. The brief psychiatric rating scale. Dimension of schizophrenia--reliability and construct validity. Psychopathology. 1989;22(2–3):168–76.CrossRef
21.
go back to reference Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry. 2007;4(7):28–37.PubMedPubMedCentral Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry. 2007;4(7):28–37.PubMedPubMedCentral
22.
go back to reference de Haan L, Weisfelt M, Dingemans PM, Linszen DH, Wouters L. Psychometric properties of the subjective well-being under neuroleptics scale and the subjective deficit syndrome scale. Psychopharmacology. 2002;162(1):24–8.CrossRef de Haan L, Weisfelt M, Dingemans PM, Linszen DH, Wouters L. Psychometric properties of the subjective well-being under neuroleptics scale and the subjective deficit syndrome scale. Psychopharmacology. 2002;162(1):24–8.CrossRef
23.
go back to reference Vothknecht S, Schoevers RA, de Haan L. Subjective well-being in schizophrenia as measured with the subjective well-being under neuroleptic treatment scale: a review. Aust N Z J Psychiatry. 2011;45(3):182–92.CrossRef Vothknecht S, Schoevers RA, de Haan L. Subjective well-being in schizophrenia as measured with the subjective well-being under neuroleptic treatment scale: a review. Aust N Z J Psychiatry. 2011;45(3):182–92.CrossRef
24.
go back to reference Naber D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol. 1995;10(Suppl 3):133–8.PubMed Naber D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol. 1995;10(Suppl 3):133–8.PubMed
25.
go back to reference Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763–8.CrossRef Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763–8.CrossRef
26.
go back to reference Gaite L, Vazquez-Barquero JL, Borra C, Ballesteros J, Schene A, Welcher B, et al. Quality of life in patients with schizophrenia in five European countries: the EPSILON study. Acta Psychiatr Scand. 2002;105(4):283–92.CrossRef Gaite L, Vazquez-Barquero JL, Borra C, Ballesteros J, Schene A, Welcher B, et al. Quality of life in patients with schizophrenia in five European countries: the EPSILON study. Acta Psychiatr Scand. 2002;105(4):283–92.CrossRef
27.
go back to reference Strauss GP, Sandt AR, Catalano LT, Allen DN. Negative symptoms and depression predict lower psychological well-being in individuals with schizophrenia. Compr Psychiatry. 2012;53(8):1137–44.CrossRef Strauss GP, Sandt AR, Catalano LT, Allen DN. Negative symptoms and depression predict lower psychological well-being in individuals with schizophrenia. Compr Psychiatry. 2012;53(8):1137–44.CrossRef
28.
go back to reference Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162(3):441–9.CrossRef Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162(3):441–9.CrossRef
29.
go back to reference Mitra S, Mahintamani T, Kavoor AR, Nizamie SH. Negative symptoms in schizophrenia. Ind Psychiatry J. 2016;25(2):135–44.CrossRef Mitra S, Mahintamani T, Kavoor AR, Nizamie SH. Negative symptoms in schizophrenia. Ind Psychiatry J. 2016;25(2):135–44.CrossRef
30.
go back to reference Yamauchi K, Aki H, Tomotake M, Iga J, Numata S, Motoki I, et al. Predictors of subjective and objective quality of life in outpatients with schizophrenia. Psychiatry Clin Neurosci. 2008;62(4):404–11.CrossRef Yamauchi K, Aki H, Tomotake M, Iga J, Numata S, Motoki I, et al. Predictors of subjective and objective quality of life in outpatients with schizophrenia. Psychiatry Clin Neurosci. 2008;62(4):404–11.CrossRef
31.
go back to reference Lambert M, Schimmelmann BG, Naber D, Schacht A, Karow A, Wagner T, et al. Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry. 2006;67(11):1690–7.CrossRef Lambert M, Schimmelmann BG, Naber D, Schacht A, Karow A, Wagner T, et al. Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry. 2006;67(11):1690–7.CrossRef
32.
go back to reference Aunjitsakul W, Teetharatkul T, Vitayanont A, Liabsuetrakul T. Does the Psychiatrist's use of subjective well-being measurement in people with schizophrenia provide a better alignment with the Patient's well-being perception than clinical judgement alone? Adm Policy Ment Health. 2021. https://doi.org/10.1007/s10488-021-01127-5. Aunjitsakul W, Teetharatkul T, Vitayanont A, Liabsuetrakul T. Does the Psychiatrist's use of subjective well-being measurement in people with schizophrenia provide a better alignment with the Patient's well-being perception than clinical judgement alone? Adm Policy Ment Health. 2021. https://​doi.​org/​10.​1007/​s10488-021-01127-5.
Metadata
Title
Associations between symptom severity and well-being among Thai patients with schizophrenia: a cross-sectional analytical study
Authors
Teerapat Teetharatkul
Arnont Vitayanont
Tippawan Liabsuetrakul
Warut Aunjitsakul
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Schizophrenia
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03358-0

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