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Comparing antipsychotic treatments for schizophrenia : a health state approach . The overall impact of first and second generation antipsychotics on quality of life and symptoms of people with schizophrenia remains controversial . We applied health state modeling to data from the Clinical Antipsychotic Trials of Intervention Effectiveness ( CATIE ) Schizophrenia study , a randomized trial of antipsychotic medications , and evaluated the likelihood of patients moving to more favorable health states over time . We applied K-means clustering to the data to create discrete groupings of patients with symptom and side effect characteristics that were then validated using quality of life measures . We compared cluster distributions across medications at baseline and 6 months after randomization . 1,049 patients were included in the initial cluster analysis . Five health states were identified : ( 1 ) low symptoms and low side effects ( LS + LSE ) ( 2 ) low symptoms and obesity ( LS + Ob ) ( 3 ) high symptoms and low side effects ( HS + LSE ) ( 4 ) high symptoms with depression and akathisia ( HS + Dp + Ak ) and ( 5 ) moderate symptoms and high side effects ( MS + HSE ) . Six-month outcomes among patients randomly assigned to perphenazine , olanzapine , risperidone and quetiapine were compared . At baseline , almost 20 % of patients were in the worst health state ( HS + Dp + Ak ) , with greater decreases at 6 months in this health state for perphenazine ( 9.2 % decrease ) and olanzapine ( 11.1 % ) groups compared to risperidone ( 4.7 % ) and quetiapine ( 6.7 % ) . This study demonstrated that health state analysis can provide insight into the overall clinical state of patients beyond the mere comparison of average scores and largely confirmed original CATIE findings .
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Intervention_Pharmacological
antipsychotics
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Intervention_Pharmacological
antipsychotic medications
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Intervention_Pharmacological
perphenazine , olanzapine , risperidone
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Intervention_Pharmacological
quetiapine
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Intervention_Pharmacological
perphenazine
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Intervention_Pharmacological
olanzapine
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Intervention_Pharmacological
risperidone
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Outcome_Other
quality of life
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Outcome_Other
symptoms
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Outcome_Physical
schizophrenia
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Outcome_Physical
more favorable health states
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Outcome_Other
symptom
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Outcome_Adverse-effects
side effect characteristics
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Outcome_Other
quality of life measures
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Outcome_Physical
depression
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Outcome_Physical
akathisia
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Outcome_Mental
worst health state
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Participant_Condition
schizophrenia :
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Participant_Condition
people with schizophrenia
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Participant_Sample-size
1,049 patients