T220. IMPACT OF SECOND-GENERATION ANTIPSYCHOTIC SIDE EFFECTS ON FUNCTIONING FROM A SCHIZOPHRENIA PATIENT PERSPECTIVE: GLOBAL PATIENT CENTERED SURVEY INCLUDING PATIENTS FROM ITALY
Bibliographic record
Abstract
Abstract Background Second-generation antipsychotics (SGAs) used to treat patients with schizophrenia generally have lower risk of motor side effects (SEs) than first-generation antipsychotics, but they are associated with other well-known SEs. The goal of this study was to understand how specific SEs of SGAs impact daily functioning, emotional well-being, and overall quality of life of patients with schizophrenia from their own perspective. Methods This study was a cross-sectional, participant-reported web survey, conducted globally during 2017–2018. The survey captured participants’ socio-demographic information, and assessments using the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) instrument, and the Glasgow Antipsychotic Side-Effect Scale (GASS). Additionally, specific questions about functional and emotional impacts were developed for SEs recognized as being bothersome to patients,2 such as activating SEs (‘Feeling restless/unable to sit still’, ‘Shaky hands or arms’, and ‘Difficulty sleeping’) sedating SEs (‘Feeling sleepy during the day’, ‘Feeling drugged/like a zombie’) and metabolic or endocrine SEs (‘Weight gain’, ‘Problems enjoying sex’). Participants noted on a visual analog scale (VAS) the degree of impact on functioning, 0 indicating ‘no impact at all’ and 100 indicating the ‘largest degree of impact’. Participants with schizophrenia (≥18 years old) stable for at least one month, taking an SGA for 1–12 months, and self-reporting at least one SE were included. Results Of 6,556 respondents screened, 435 were included in the study – United States, n=180; Canada, n=99; Australia, n=28; and Europe, n=128 (Italy, n=90; Spain, n=22; Denmark, n=8; Norway, n=8). The majority of the participants were diagnosed within the last 5 years and nearly half were living with a spouse or partner. The employment rate (full time or part time) was 39.9% globally and 43.3% in Italy. Respondents in Italy were on ‘predominantly sedating’ (54.4%), and/or ‘similarly activating and sedating’ (43.3%) SGAs (as defined in Citrome, J Clin Psychopharmacol 2017). In Italy, Q-LES-Q-SF total score was (mean [standard deviation; SD]) 46.6 [9.1], out of a possible score range of 14–70 (globally, 44.3 [9.8]). Similar to other countries, participants from Italy showed lowest satisfaction scores for Q-LES-Q-SF items of ‘Sexual drive, interest and/or performance’, ‘Economic status’, and ‘Work’. In Italy, the most prevalent SEs reported on the GASS were ‘Feeling sleepy during the day’, ‘Difficulty sleeping’, and ‘Problems enjoying sex’, while globally patients reported ‘Feeling sleepy during the day’, ‘Difficulty sleeping’, and ‘Dry mouth’ as the most common SEs. More than half of the participants stated they had experienced gaining weight as an SE (52.4% globally and 62.2% in Italy). Globally, SEs perceived as bothersome by patients were reported to impact participants’ functioning and emotions. These SEs had at least a moderate to severe impact (defined by a VAS score ≥50) on all aspects of functioning (physical, psychological, social, and vocational). The most common emotions associated with SEs reported by participants were feeling ‘Frustrated’, ‘Dissatisfied’, and ‘Ashamed/embarrassed’. Generally, the results from the survey in Italy were comparable to those of the global survey. Discussion Findings from this survey confirm that participants taking SGAs for the treatment of schizophrenia still have many SEs, including activating and sedating SEs, sexual SEs, and weight gain. These SEs have a considerable negative impact on participant’s daily functioning and quality of life satisfaction, including on work, and sexual drive, in addition to psychosocial effects.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".