Psychiatry Investig.  2021 Oct;18(10):968-976. 10.30773/pi.2021.0190.

Associations of Clozapine Use With Psychosocial Functioning and Quality of Life in Patients With Schizophrenia: A Community-Based Cross-Sectional Study

Affiliations
  • 1Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
  • 2Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • 3Seongnam Community Mental Health Welfare Center, Seongnam, Republic of Korea
  • 4Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
  • 5Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea

Abstract


Objective
More attempts have been made recently to improve psychosocial functioning and quality of life in patients with schizophrenia, due to their crucial role in long-term outcomes. Previous studies on the effects of clozapine on psychosocial functioning have been limited in terms of generalizability and application to clinical practice. This study examined the relationship of clozapine use with psychosocial functioning and quality of life in patients with schizophrenia in a real-world setting.
Methods
Data were obtained from a survey targeting community-dwelling patients with schizophrenia. The Behavior and Symptom Identification Scale (BASIS) and Satisfaction with Life Scale (SWLS) were administered to evaluate psychosocial functioning and quality of life, and patients were classified into Clozapine and Non-clozapine groups. Group differences were assessed using ANCOVA, with additional sensitivity analyses for participants on atypical antipsychotic medications only.
Results
Of 292 patients, the Clozapine group (n=34) had significantly better psychosocial functioning and quality of life than the Nonclozapine group (n=258), as demonstrated by their low BASIS score (F=4.651, df=1, 290, p=0.032) and high SWLS score (F=14.637, df=1, 290, p<0.001). Similar findings for psychosocial outcomes were observed in the analyses of the atypical antipsychotic subgroup (n=195).
Conclusion
For optimal recovery in schizophrenia, restoration of impaired social functioning and enhanced satisfaction with life are essential. In this study, clozapine use was related to high levels of psychosocial functioning and quality of life in real-world settings. Further research on the causal relationship between clozapine use and psychosocial functioning is needed.

Keyword

Antipsychotic agents; Clozapine; Psychosocial functioning; Quality of life; Schizophrenia
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