Influence of psychopathological symptoms on subjective quality of life of schizophrenic patients

The aim of this paper was to investigate whether changes of psychopathological symptoms are associated with subjective quality of life of schizophrenic patients during therapy with flupenthixol or risperidone. In this multicenter, double-blind trial the efficacy of flupenthixol compared to risperidone in enhancing the quality of life of 153 chronic schizophrenic patients was investigated. We evaluated the possible influence of psychopathological symptoms, assessed by means of the five factors of the positive and negative syndrome scale (PANSS) - (1) "negative-symptoms", (2) "uncontrolled hostility/excitement", (3) "disorganized thought", (4) "anxiety/depression", (5) "positive-symptoms" - on subjective quality of life, measured by the EuroQuol visual scale and the patients' satisfaction questionnaire, as well as on attitude towards medication, measured by the drug attitude inventory 30 (DAI-30). Additionally all single items of the PANSS were compared in both treatment groups after 24 weeks to baseline data. In both treatment groups the decrease of the PANSS factors "negative-symptoms", "anxiety/depression", "disorganized thought" and "positive-symptoms" correlated statistically significant with the increase on the EuroQuol scale; an improved overall score of the patients' satisfaction questionnaire correlated with the decrease of "negative-symptoms" with both medications as well as with an amelioration of "disorganized thoughts" and "anxiety/depression" with risperidone. Regarding an improved attitude towards medication a correlation of improved "negative-symptoms" was found with flupenthixol as well as with improved "disorganized thoughts" and "anxiety/depression" with risperidone. Comparing both therapies the PANSS single item "depression" improved significantly after 24 weeks in advantage of flupenthixol and the single item "grandiosity" improved in advantage of risperidone (ITT-analysis, nominal p < 0.05). From this study we concluded that in our group of patients the improvement of psychopathological symptoms (negative-symptoms, anxiety/ depression, disorganized thought and positive-symptoms) during a therapy with flupenthixol or risperidone correlates with improved subjective quality of life.