Article

Subjective utility ratings of neuroleptics in treating schizophrenia

Department of Psychology, University of Texas, Austin 78712.
Psychological Medicine (Impact Factor: 5.43). 12/1990; 20(4):843-8. DOI: 10.1017/S0033291700036539
Source: PubMed

ABSTRACT This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rates the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.

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    • "Is the clinician's perspective overlapping with the patient's perspective? Finn et al. (1990), who carried out a study that measured the subjective burden of both psychotic symptoms and medication side effects in patients and clinicians, found that the side effects of antipsychotics were perceived as being as troublesome as the symptoms they were being used to treat by patients; psychiatrists, by contrast, considered side effects less bothersome than symptoms. Moreover, a substantial disagreement between patients' and psychiatrists' ratings of troublesomeness of specific side effects was found. "
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    Epidemiologia e psichiatria sociale 09/2008; 17(3):182-5. DOI:10.1017/S1121189X00001251 · 3.16 Impact Factor
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    • "Routinely and sensitively questioning patients with schizophrenia about their sexual function is an important initial approach that may improve therapeutic outcomes (Kelly and Conley, 2003). Sexual dysfunction is considered by many schizophrenia patients to be more troublesome than most other symptoms and adverse drug effects (Finn et al., 1990; Lambert et al., 2004) and is a major cause of poor quality of life (Olfson et al., 2005), negative attitude to therapy and treatment non-compliance (Lambert et al., 2004). In an assessment of schizophrenia patients treated with conventional antipsychotics, those who experienced sexual dysfunction were significantly ( p < 0.001) more at risk of developing a negative attitude towards treatment and, therefore, at risk of later non-adherence compared with those who experienced sedative or vegetative side effects (Lambert et al., 2004). "
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    • "We are not aware of any studies on the correlation between compliance and sexual side effects due to antipsychotic drugs. Studies suggest that clinicians tend to underestimate the frequency and importance of sexual side effects in patients with schizophrenia (Finn et al. 1990; Peuskens et al. 1998) and other psychiatric disorders (Singh and Beck 1997). Further research is required on sexual side effects induced by antipsychotics, the possible mechanisms involved and on the relationship of specific side effects on compliance. "
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