Clozapine in schizophrenia and its association with treatment satisfaction and quality of life: Findings of the three national surveys on use of psychotropic medications in China (2002-2012).

Abstract

OBJECTIVE:

We examined the time trends and correlates of clozapine use in schizophrenia patients in China.

METHOD:

A total of 14,013 patients with schizophrenia treated in 45 psychiatric hospitals/centers nationwide were interviewed in 2002, 2006 and 2012. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects, satisfaction with treatment and quality of life (QOL) were recorded in a standardized fashion.

RESULTS:

Clozapine was used in 32.9% of the whole sample; with corresponding figures of 39.7%, 32.5% and 26.4% in 2002, 2006 and 2012 (p<0.001). Families of clozapine users had lower satisfaction with treatment than those of the non-clozapine group, without significant differences with respect to patients' treatment satisfaction and mental or physical QOL. In multiple logistic regression analyses, compared to the non-clozapine group, patients on clozapine had an earlier age of onset, longer illness duration, more global illness severity and drug-induced central nervous system, gastrointestinal and other side effects, lower antipsychotic doses, less delusions and hallucinations, more negative symptoms, were more likely male, inpatients, to have a family history of psychiatric disorders, receive treatments in regional centers and receive antipsychotic polypharmacy, but less likely to have health insurance and receive first-generation antipsychotics and benzodiazepines (R(2)=0.498, p<0.001).

CONCLUSIONS:

Clozapine was used in one-third of schizophrenia patients in China, with decreasing frequency since 2002. Patients prescribed clozapine had multiple markers of greater global illness severity/chronicity and decreased satisfaction with treatment by the families, but similar QOL and less delusions and hallucinations than patients not prescribed clozapine.

• Authors: Qian Li, Yu-Tao Xiang, Yun-Ai Su, Liang Shu, Xin Yu, Christoph U Correll, Gabor S Ungvari, Helen F K Chiu, Cui Ma, Gao-Hua Wang, Pei-Shen Bai, Tao Li, Li-Zhong Sun, Jian-Guo Shi, Xian-Sheng Chen, Qi-Yi Mei, Ke-Qing Li, Tian-Mei Si, John M Kane
• Journal: Schizophrenia research (Schizophr Res) Vol. 168 Issue 1-2 Pg. 523-9 (Oct 2015) ISSN: 1573-2509 [Electronic] Netherlands
• PMID: 26277534 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier B.V. All rights reserved.

Chemical References

• Antipsychotic Agents
• Clozapine

Topics

• Adult
• Antipsychotic Agents (adverse effects, therapeutic use)
• China (epidemiology)
• Clozapine (adverse effects, therapeutic use)
• Cross-Sectional Studies
• Humans
• Inpatients (psychology, statistics & numerical data)
• Logistic Models
• Male
• Patient Satisfaction (statistics & numerical data)
• Practice Patterns, Physicians'
• Quality of Life
• Schizophrenia (drug therapy, epidemiology)
• Schizophrenic Psychology
• Time Factors