What does this research mean for the field?

Cariprazine leads to superior improvements in negative symptoms and social quality of life compared to risperidone in patients with schizophrenia. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

To compare the effects of cariprazine and risperidone on biopsychosocial outcomes in individuals with schizophrenia.

March 14, 2026Open Access

Antipsychotics and their Impact on Biopsychosocial Outcomes in Schizophrenia: A Randomized Comparative Study

Key Points

To compare the effects of cariprazine and risperidone on biopsychosocial outcomes in individuals with schizophrenia.
Randomized controlled trial with 65 adults diagnosed with schizophrenia
Participants received either cariprazine or risperidone for 10 weeks
Primary endpoints assessed include BPRS and PANSS scores; secondary endpoints include WHOQOL-BREF, SOFS, and ASEX scores
Correlation analyses were performed to evaluate the relationship between symptom severity and biopsychosocial outcomes.
Both antipsychotics had comparable PANSS-total scores after 10 weeks (P = 0.931)
Cariprazine showed significantly lower negative symptoms (P < 0.001) and improved social relationship scores (P = 0.001)
BPRS changes favored risperidone (P < 0.001)
Trends in ASEX scores favored cariprazine
Strong correlations observed between symptom reductions and WHOQOL-general and psychological health domains (r ≈ −0.9, P < 0.001).

Abstract

Background: Functional recovery and social integration are central goals in schizophrenia treatment, yet are seldom evaluated alongside symptom remission. Traditional trials prioritize psychosis reduction, overlooking quality-of-life (QoL), social functioning, and sexual health domains critical to personal and social recovery. Objective: To compare the impact of two antipsychotics on biopsychosocial outcomes i.e., QoL, socio-occupational functioning, and sexual functioning and to assess symptom severity correlations with these biopsychosocial outcomes. Methods: In this randomized study, 65 adults with schizophrenia received either cariprazine ( n = 33) or risperidone ( n = 32) for 10 weeks. Primary endpoints were change in Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS) scores. The secondary endpoints comprised World Health Organization Quality of Life-Brief scale (WHOQOL-BREF), Social Occupational Functioning Scale (SOFS), and Arizona Sexual Experience Scale (ASEX) scores. Pearson correlations (i.e. ‘r’) assessed associations between symptoms and biopsychosocial outcomes. Results: At 10 weeks, both groups achieved comparable PANSS-total scores ( P = 0.931). Cariprazine led to significantly lower negative symptoms ( P < 0.001) and higher social relationship domain score, i.e., WHOQOL-D3 ( P = 0.001). BPRS change favored risperidone ( P < 0.001). SOFS and other WHOQOL domains were comparable. ASEX score trends favored cariprazine. Symptom reductions correlated strongly with WHOQOL-general and psychological health domain, i.e., WHOQOL-D2 ( r ≈ −0.9, P < 0.001; for both), moderately with WHOQOL-D3 ( r ≈ −0.5 to − 0.8, P < 0.001) and ASEX ( r ≈ 0.35), and weakly with SOFS ( r ≈ 0.19). Conclusion: While both antipsychotics yielded comparable symptom control, cariprazine demonstrated superior benefits in negative symptoms and social QoL. Integrating psycho-social and biological measures in therapeutic evaluation emphasizes the importance of functional recovery in schizophrenia care.

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