Chronic diseases as schizophrenia and psychotic disorder requires a long time therapy and patient’s insight is compromised. In this kind of pathology the compliance is an essential requisite. The compliance is related to a good subjective wellbeing.
The research assesses compliance, well-being and insight in patients with schizophrenia, schizo-affective disorder and psychotic disorder NOS treated with atypical antipsychotics (olanzapine, risperidone, aripiprazolo). A one year study evaluates 58 patients, (range 25- 65 years) affected by schizophrenia, schizoaffective disorder and psychotic disorder NOS. The primary outcome was clinical response as defined by SAPS, SANS, and BPRS. The secondary outcome included tolerability and the side effects defined as either: blood parameters (total cholesterol, triglycerides, glucose and prolactin); weight; blood pressure; QTc (ECG); anti-cholinergic and extra-pyramidal effects; AIMS. The third outcome was insight and subjective well-being examineted with ITAQ and PGWBI. The research included an evaluation at baseline and 3 follow-up (at 3, 6-months and 12-months).
Study has shown reduction of the total score of the scales: in patients treated with OLA BPRS (p = 0.0001), SAPS (p = 0.0061) and SANS (p = 0, 0091); in patients treated with RSP SANS and SAPS (p = < 0.0001); ITAQ shows a statistical important improvement at T2 in all groups (p = 0.007); in the PGWBI there is an increase of the total score in all groups (p < 0.001) between T0 and T2. Results about Tolerability have shown an increase in average weight of 3.4 kg in patients treated with OLA and an increase of prolactin (45-50%) in patients treated with RSP. AIMS didn’t show high scores.
The increased insight, related to good cardiovascular tolerability and therapeutic efficacy, has contributed to the adherence of treatment (92%), with a significant improvement in psychomotor and cognitive performance. The pharmacological differences between atypical antipsychotics must be considered in the individual therapeutic prescription. An appropriate psycho-pharmacological prescription is important to the subjective’s perception of well-being.