Subjective experiences of schizophrenic patients treated with antipsychotic medication

Patients with schizophrenia on maintenance neuroleptic medication report emotional and cognitive deficits and reduced quality of life, a syndrome termed pharmacogenic depression or neuroleptic-induced deficit syndrome. Although these subjective side effects are likely to be related to poor compliance, they have not been thoroughly and systematically investigated. A self-rating scale has been developed to measure subjective well-being under neuroleptic treatment, the SWN. This scale was tested in 280 patients shortly before discharge from inpatient treatment and it was found to be sensitive, reliable and practical. Ninety per cent of patients completed the scale within 20 min and inconsistencies in response were no greater than among a sample of depressed patients. Scores on the SWN were significantly correlated with objective measures of psychopathology and more highly correlated with other self-rating measures of mood and with quality-of-life measures. Patients on clozapine rated well-being more highly than those on classical neuroleptics. Only patients whose medication was altered showed changed SWN scores with time. Low SWN scores at discharge were associated with non-compliance 4–6 months later. The subjective side effects of neuroleptics are measurable and of relevance to compliance and should be given greater consideration in clinical trials and in psychiatrists' daily practices.