Gesundheitsökonomie & Qualitätsmanagement , Thieme Verlag Heft 4-2008, Jahrgang 13) ISSN 1432-2625 Seite(n) 220 bis 227 DOI: 10.1055/s-2008-1027620 CareLit-Dokument-Nr: 318600 |
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Corrected by: ErratumGesundheitsökonomie & Qualitätsmanagement 2008; 13(05): 304-304 DOI: 10.1055/s-2008-1027916 Zusammenfassung Zielsetzung: Ziel dieser Studie war es, den Zusammenhang zwischen klinischen Variablen und subjektivem Wohlbefinden unter Neuroleptikaeinnahme (SWN) an zwei Gruppen schizophrener Patienten (Behandlung mit Olanzapin oder Haloperidol) zu bestimmen und zu untersuchen. Methodik: Für mit Olanzapin (n = 308) bzw. mit Haloperidol (n = 188) behandelte schizophrene Patienten, die die Kurzfassung des SWN-20-Fragebogens ausgefüllt hatten, wurden separate MIMIC-Modelle getestet. Anhand der Korrelationsmatrix der Antwortscores (mit Standardabweichungen) der MIMIC-Modelle wurde geprüft, wie der Schweregrad der Schizophrenie (CGI) und die extrapyramidalen Nebenwirkungen (EPS) – nach Beurteilung des Arztes – das subjektive Wohlbefinden unter Neuroleptika – nach Einschätzung der Patienten – beeinflussen. Ergebnisse: Der Schweregrad der Schizophrenieerkrankung beeinflusste das subjektive Wohlbefinden, insbesondere den emotionalen und körperlichen Bereich, sowie die Selbstkontrolle. Kognitive Symptome wirkten sich bei Patienten unter Haloperidol, nicht aber unter Olanzapin, auf den SWN aus (β = –0,23). Insgesamt hatte der Schweregrad der Erkrankung einen deutlicheren Einfluss auf den SWN als die extrapyramidalen Nebenwirkungen (erklärte Varianz 0,26 vs. 0,11 für Haloperidol sowie 0,22 vs. 0,02 für Olanzapin). Schlussfolgerungen: Generell finden sich zwischen klinischem Schweregrad und SWN deutliche, zwischen EPS und SWN jedoch nur schwache Zusammenhänge. Hierbei spielt die Überlappung zwischen kognitiven, emotionalen und physischen Störungen und dem Neuroleptikainduzierten Defizitsyndrom (NIDS) für die Dimensionen eine besondere Rolle. Dies spiegelt die Bedeutung des NIDS für die subjektive Lebensqualität von Menschen mit schizophrenen Psychosen wider. Abstract Aim: The objectives of this study were to determine and to test relations between clinical variables and subjective well-being under neuroleptics (SWN) in two groups of patients with schizophrenia treated with olanzapine or haloperidol. Method: For patients with schizophrenia who completed the SWN-20 (short version) questionnaire and were treated with olanzapine (n = 308) or haloperidol (n = 188), separate multiple-indicator multiple-cause (MIMIC) models were programmed. Based on a correlation matrix of the scores of answers and their standard deviations, the MIMIC models were used to evaluate the influence of disease severity (CGI) and extrapyramidal adverse effects (EPS) as assessed by the physicians on the SWN as assessed by the patients were evaluated. Results: Schizophrenia disease severity influenced the SWN, most of all its emotional, self control and physical dimensions. In the haloperidol group but not in the olanzapine group, cognitive symptoms were found to affect the SWN (β = –0.23). The SWN was more strongly influenced by disease severity than by the EPS (explained variance of 0.26 vs. 0.11 for haloperidol and 0.22 vs. 0.02 for olanzapine groups, respectively). Conclusion: Cognitive, emotional and physical impairment overlapping with neuroleptic-induced deficit syndrome (NIDS) play a vital role in the SWN dimensions. This reflects the importance of NIDS on subjective well-being in people with schizophrenia. Schlüsselwörter MIMIC - Schizophrenie - Strukturgleichungsmodell - SWN Key words MIMIC - schizophrenia - SEM - SWN References 1 McSweeny A J, Creer T L. Health-related quality-of-life assessment in medical care. Dis Mon. 1995; 41 1-71 Google Scholar 2 Guyatt G H, Feeny D H, Patrick D L. Measuring health-related quality of life. Ann Intern Med. 1993; 118 622-629 Google Scholar 3 Ritsner M, Modai I, Endicott J. et al . 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