Mohr Pavel
Psychiatric Centre Prague, 3rd School of Medicine, Charles University Prague, Czech Republic.
Neuro Endocrinol Lett. 2007 Feb;28 Suppl 1:117-33.
Health-related quality of life (QoL) represents important measure of treatment outcome in mental disorders. Numerous studies indicate that QoL of people with schizophrenia and bipolar disorder is similar to that of patients with chronic physical conditions. It has been shown that schizophrenia patients can themselves reliably assess their QoL; in addition to the objective scales various self-reporting instruments are used. Patients with bipolar disorder have QoL consistently higher than patients with schizophrenia and similar to that found in people with unipolar depression. Quality of life can be negatively affected by drug-induced side-effects and subjective treatment response. The second-generation antipsychotics (SGA) have superior efficacy on QoL over classical antipsychotics in approximately half of the studies with schizophrenia; in the other half those groups are comparable. However, in none of the trials novel antipsychotics were inferior. All SGA (clozapine, olanzapine, risperidone, amisulpride, quetiapine, ziprasidone, or remoxipride) have been found to be beneficial for patients well-being. The most investigated drugs that convincingly improve QoL in schizophrenia are olanzapine and risperidone (including depot form). Results of several studies indicate that individual antipsychotics may differ in their effects on QoL, with suggested superiority of olanzapine. In bipolar disorder, SGA consistently showed their superiority over placebo in effects on QoL. The most studied SGA in bipolar disorder is olanzapine. More long-term controlled double-blind trials are needed to definitively uphold superiority and different effects of individual SGA on QoL of patients with schizophrenia and bipolar disorder.
健康相关生活质量（QoL）是精神障碍治疗效果的重要衡量指标。大量研究表明，精神分裂症和双相情感障碍患者的生活质量与慢性身体疾病患者相似。研究表明，精神分裂症患者能够可靠地自行评估其生活质量；除了客观量表外，还使用了各种自我报告工具。双相情感障碍患者的生活质量始终高于精神分裂症患者，与单相抑郁症患者相似。生活质量可能会受到药物副作用和主观治疗反应的负面影响。在大约一半针对精神分裂症的研究中，第二代抗精神病药物（SGA）在生活质量方面的疗效优于经典抗精神病药物；在另一半研究中，这两组药物相当。然而，在所有试验中，新型抗精神病药物都没有表现出劣势。所有SGA（氯氮平、奥氮平、利培酮、氨磺必利、喹硫平、齐拉西酮或瑞莫必利）都被发现对患者的幸福感有益。在精神分裂症中，最常被研究且能令人信服地改善生活质量的药物是奥氮平和利培酮（包括长效剂型）。多项研究结果表明，不同的抗精神病药物对生活质量的影响可能不同，有研究表明奥氮平具有优势。在双相情感障碍中，SGA在生活质量方面的效果始终优于安慰剂。在双相情感障碍中研究最多的SGA是奥氮平。需要更多长期对照双盲试验来明确证实不同SGA对精神分裂症和双相情感障碍患者生活质量的优势和不同影响。
