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Subjective utility ratings of neuroleptics in treating schizophrenia*

  • Stephen E. Finn (a1), J. Michael Bailey (a1), Robert T. Schultz (a1) and Raymond Faber (a1)
  • DOI: http://dx.doi.org/10.1017/S0033291700036539
  • Published online: 01 July 2009
Abstract
Synopsis

This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rated the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.

Copyright
Corresponding author
1Address for correspondence: Dr Stephen E. Finn, Mezes Hall 330, University of Texas, Austin, TX 78712, USA.
Footnotes
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Parts of this paper were presented at the meeting of the Society of Biological Psychiatry, 7 13 May 1988, Montreal, Canada.

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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

T. R. Crow (1985). The two syndrome concept: origins and current status. Schizophrenia Bulletin 11, 471485.

S. E. Finn (1982). Base rates, utilities, and DSM-III: shortcomings of fixed-rules systems of psychodiagnosis. Journal of Abnormal Psychology 91, 294302.

S. C. Hayes , R. O. Nelson & R. B. Jarrett (1987). The treatment utility of assessment: a functional approach to evaluating assessment quality. American Psychologist 42, 963974.

P. E. Meehl & A. Rosen (1955). Antecedent probability and the efficiency of psychometric signs, patterns, or cutting scores. Psychological Bulletin 52, 194216.

L. G. Rorer , P. J. Hoffman & K. C. Hsieh (1966). Utilities as base-rate multipliers in the determining of optimum cutting scores for the discrimination of groups of unequal size and variance. Journal of Applied Psychology 50, 364368.

R. L. Spitzer , N. C. Andreasen & J. Endicott (1978). Schizophrenia and other psychotic disorders in DSM-III. Schizophrenia Bulletin 4, 489494.

T. S. Szasz (1957). Some observations on the use of the tranquilizing drugs. Archives of Neurological Psychiatry 77, 8692.

T. Van Putten (1974). Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry 31, 6772.

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Psychological Medicine
  • ISSN: 0033-2917
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