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Takeuchi H, Fervaha G, Remington G. Reliability of a patient-reported outcome measure in schizophrenia: Results from back-to-back self-ratings. Psychiatry Res 2016; 244:415-9. [PMID: 27543916 DOI: 10.1016/j.psychres.2016.07.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/28/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
This study aimed to assess patient's capacity to perform a patient-reported outcome (PRO) measure (i.e., a self-rating scale) and examine its relationship with clinical characteristics including cognition. Fifty patients with schizophrenia were asked to rate the Subjective Well-being under Neuroleptics scale - Short form (SWNS) twice; the second rating was started immediately after they completed the first to minimize the gap between ratings. At the same time, the Positive and Negative Symptoms Scale (PANSS) and Brief Neurocognitive Assessment (BNA) were administered. The correlations between the two ratings for the SWNS total and each item scores were high (rs=0.94 and rs=0.60-0.84, respectively); however, for 16 (80%) of 20 items, 5 or more patients (i.e., ≥10%) demonstrated a>1 point score difference. There was no significant correlation between the SWNS total score difference and any clinical characteristics including age, education duration, illness duration, antipsychotic dose, psychopathology, and cognition. In contrast, the number of items with a>1 point score difference was significantly correlated with disorganized symptoms and overall severity (rs=0.29 for both), as well as working memory and global cognition (rs=-0.41 and rs=-0.40, respectively). These findings suggest that PROs should be interpreted with caution in patients with schizophrenia with prominent disorganization and cognitive impairment.
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Affiliation(s)
- Hiroyoshi Takeuchi
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| | - Gagan Fervaha
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Gary Remington
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
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Takekita Y, Koshikawa Y, Fabbri C, Sakai S, Sunada N, Onohara A, Nishida K, Yoshimura M, Kato M, Serretti A, Kinoshita T. Cognitive function and risperidone long-acting injection vs. paliperidone palmitate in schizophrenia: a 6-month, open-label, randomized, pilot trial. BMC Psychiatry 2016; 16:172. [PMID: 27236412 PMCID: PMC4884618 DOI: 10.1186/s12888-016-0883-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 05/24/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Recently, long-acting injection (LAI) of second-generation antipsychotics has become a valuable strategy for the treatment of schizophrenia. However, few studies have compared the effects of different LAI antipsychotics on cognitive functions so far. The present study aimed to compare the influence of risperidone LAIs (RLAI) and paliperidone palmitate LAIs (PP) on cognitive function in outpatients with schizophrenia. METHODS In this 6-month, open-label, randomized, and controlled study, 30 patients with schizophrenia who were treated with RLAIs were randomly allocated to the RLAI-continued group or the PP group. At baseline and 6 months, the patients were evaluated using the Brief Assessment of Cognition in Schizophrenia (BACS) that was the primary outcome of the study. The Subjective Well-being under Neuroleptic drug treatment-Short form (SWNS), the Positive and Negative Syndrome Scale (PANSS), and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) scores were secondary outcome variables and they were tested at the same time points. RESULTS The two groups did not differ in terms of PANSS, DIEPSS, or SWNS total score changes. However, the BACS score for the attention and processing speed item showed higher improvement in the PP group than the RLAI group (p = 0.039). CONCLUSIONS The results of this preliminary study suggest that PPs may improve attention and processing speed more than RLAIs. Anyway, a replication in a larger and double-blind study is needed. TRIAL REGISTRATION UMIN000014470 . Registered 10 July 2014.
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Affiliation(s)
- Yoshiteru Takekita
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, Bologna, 40123, Italy. .,Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka, 570-8507, Japan.
| | - Yosuke Koshikawa
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Chiara Fabbri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, Bologna, 40123 Italy
| | - Shiho Sakai
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Naotaka Sunada
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Ai Onohara
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Keiichiro Nishida
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Masafumi Yoshimura
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, Bologna, 40123 Italy
| | - Toshihiko Kinoshita
- Department of Neuropsychiatry, Kansai Medical University, 10-15 fumizono-cho, Moriguchi-shi, Osaka 570-8507 Japan
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Park IJ, Jung DC, Hwang SSH, Jung HY, Yoon JS, Kim CE, Ahn YM, Kim YS. Refinement of the SWN-20 based on the Rasch rating model. Compr Psychiatry 2015; 60:134-41. [PMID: 25819763 DOI: 10.1016/j.comppsych.2014.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 12/15/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The aim of the present study was to refine the 20-item Subjective Well-Being under Neuroleptic Treatment Scale (SWN-20) using the Rasch rating model to validate measurements of subjective well-being in patients with schizophrenia undergoing antipsychotic treatment. METHODS In total, 854 (403 males, 451 females) inpatients (n=213) and outpatients (n=641) with schizophrenia participated in this study, which was designed as an open-label investigation of paliperidone extended release. The participants completed the Korean version of the SWN-20 themselves. Refinement of the Korean version of the SWN-20 was accomplished using the Rasch rating model. RESULTS Infit and outfit statistics for all 20 items satisfied the criterion for construct validity. Second, all items except items 2 and 20 had suitable point-measure correlations, reflecting content validity. Third, item characteristic curves indicated that roughly 18 items were evenly distributed along the person ability continuum. Finally, option analysis of the category characteristics showed that categories 3 and 4 in the SWN-20 response format were unnecessary. CONCLUSIONS We offer several recommendations for improving the SWN-20: (a) items 2 and 20 should be omitted to ensure construct validity; (b) easier items would be added related to the person ability estimates in the process of validating a short form of the SWN scale based on item response theory; and (c) the number of response categories should be reduced for schizophrenic patients.
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Affiliation(s)
- In-Jo Park
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Dong Chung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - Hee Yeon Jung
- Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Chul-Eung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Yong Sik Kim
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea; Institute of Clinical Psychopharmacology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
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