Subjective well-being in schizophrenia as measured with the Subjective Well-Being under Neuroleptic Treatment scale: a review

Objective: The Subjective Well-being under Neuroleptic Treatment scale (SWN) is the most widely used self-rating scale in recent research of subjective well-being in schizophrenia. We reviewed all available publications on relevant research of subjective well-being using the SWN, in order to evaluate measurement of subjective well-being with a single instrument. Method: A MEDLINE and Embase search was performed for studies published between January 1994 and August 2010, analysing controlled and open clinical trials using the SWN. Results: A total of 52 publications were identified covering 44 studies. Strong evidence exists for improvement of subjective well-being during treatment. Atypical antipsychotics are associated with a higher level of well-being. However, dosage is more important than the kind of medication. Striatal dopamine D-2 receptor occupancy is correlated with subjective well-being. Early positive response of subjective well-being is predictive of a better outcome. Research on determinants of subjective well-being is rapidly expanding, focusing mostly on the effects of medication. Conclusions: Subjective well-being of schizophrenia patients is a valuable outcome measure. It can be improved by optimizing antipsychotic treatment. More research on psychological and genetic predictors of subjective well-being is needed.