Differential effects of antipsychotics on quality of life and functioning in Chinese patients with first-episode psychosis

Abstract

BACKGROUND: Meta-analysis of RCTs suggested that patients with second generation antipsychotic treatment have higher functioning and quality of life than those with first generation antipsychotic treatment. However, findings from CATIE and CUtLASS raised doubt about their difference in real clinical settings, especially in patients with first-episode psychosis. We compared the effects of antipsychotics on quality of life and functioning in Chinese patients with first-episode psychosis. METHODS: A total of 285 patients were assessed with the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Udvalg for Kliniske Undersogelser (UKU), the Social and Occupational Functioning Assessment Scale (SOFAS), the Role Functioning Scale (RFS) and the Medical Outcomes Study Short Form 12-Item Health Survey (SF-12) after stabilization of mental condition. Difference between individual antipsychotic medications was investigated using ANOVA and post-hoc analysis. RESULTS: Significant differences were found between different antipsychotic medications in the mean of UKU neurological subscore, BARS total score, SOFAS score and SF-12 mental component summary score (MCS) score. Patients with haloperidol had higher mean UKU neurological subscore than patients with olanzapine or amisulpiride. Patients with risperidone had higher mean BARS total score than patients with olanzapine, amisulpiride or sulpiride. Patients with amisulpiride had higher mean MCS than patients with risperidone. DISCUSSION: Antipsychotics have differential effects on quality of life and functioning in patients with first episode psychosis. Future prospective study is warranted to investigate if patients with first episode psychosis will benefit from specific type of antipsychotics more than the others.