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The interaction of subjective experience and attitudes towards specific antipsychotic-related adverse effects in schizophrenia patients

Published online by Cambridge University Press:  15 April 2020

T. Fischel ,
A. Krivoy ,
M. Kotlarov ,
Z. Zemishlany ,
O. Loebstein ,
H. Jacoby  and
A. Weizman
T. Fischel
Affiliation:
Geha Mental Health Center, 1, Helsinki Street, P.O. Box 103, 49100Petach-Tikva, Israel Sackler's Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
A. Krivoy*
Affiliation:
Geha Mental Health Center, 1, Helsinki Street, P.O. Box 103, 49100Petach-Tikva, Israel Sackler's Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
M. Kotlarov
Affiliation:
Sackler's Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Z. Zemishlany
Affiliation:
Geha Mental Health Center, 1, Helsinki Street, P.O. Box 103, 49100Petach-Tikva, Israel Sackler's Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
O. Loebstein
Affiliation:
Geha Mental Health Center, 1, Helsinki Street, P.O. Box 103, 49100Petach-Tikva, Israel Sackler's Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
H. Jacoby
Affiliation:
Geha Mental Health Center, 1, Helsinki Street, P.O. Box 103, 49100Petach-Tikva, Israel
A. Weizman
Affiliation:
Geha Mental Health Center, 1, Helsinki Street, P.O. Box 103, 49100Petach-Tikva, Israel Sackler's Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Felsenstein Medical Research Center, Petach-Tikva, Israel
*
*Corresponding author. Tel.: +972 3 925 8230; fax: +972 3 925 8235. E-mail address:Krivoy@zahav.net.il (A. Krivoy).
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Abstract

Background:

Discontinuation of antipsychotic drugs in schizophrenia patients is a major concern, since it results in relapse and re-hospitalizations. Non-adherence is strongly associated with negative-subjective response to antipsychotics, which is composed of the subjective experience of negative drug effects and attitude towards the treatment.

Objective:

To investigate the elements of subjective experience and subjective attitude towards specific drug-related adverse effects, leading to a generally negative-subjective attitude towards antipsychotics.

Methods:

Schizophrenia inpatients (n = 84) were administered a questionnaire measuring attitude and experience on eight subscales: weight gain, sedation, sexual anhedonia, extra-pyramidal syndrome, affective flattening, excessive sleep, diminished sociability and metabolic syndrome. DAI-30 was used to measure attitude towards drugs, and PANSS to assess psychopathology.

Results:

Weak correlation was found between subjective experience and attitude on most of the subscales. The only strong, albeit inverse, correlation between experience and attitude that was found was with regard to affective flattening, experienced by 37% of the sample, and it also predicted negative drug attitude as measured by the DAI-30, RR: 1.87 (95% CI: 1.06–3.3, df = 1, χ2 = 4.525, P < 0.05).

Conclusion:

Negative attitude towards most adverse drug effects did not correlate with personal experience. Drug-related affective flattening should be evaluated routinely, since experiencing it may predict negative attitude towards drugs, potentially leading to poor compliance and relapse.

Keywords

SchizophreniaAntipsychotic drugsSubjective attitudeSubjective experienceAffective flattening
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 6 , August 2013 , pp. 340 - 343
Copyright
Copyright © European Psychiatric Association

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Footnotes

1

Both authors contributed equally to this manuscript.

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