Perception of Quality of Life (QoL) in patients on antipsychotic treatment may differ depending on the perspective. This prospective, naturalistic study looked at differences between the "objective" physician perspective using the Quality of Life Scale (QLS) and the "subjective" patient perspective using the Subjective Well-being on Neuroleptics Scale (SWN).

Data were collected in a prospective, 12-month, prospective naturalistic study in 1462 outpatients on antipsychotic treatment for schizophrenia. Patients were grouped into 4 cohorts depending on the degree of concordance between SWN and QLS ratings. The impact of factors on the concordance was expressed as adjusted odds ratio (OR; QLS=SWN used as reference group).

Linear correlation was found between QLS and SWN ratings: 10 points on the SWN corresponded to 9.35 points on the QLS. Several factors affecting the concordance of both ratings were identified: Compared to the cohort with QLS=SWN, higher QOL ratings by the physician (QLS>>SWN) were more likely in females than in males (OR=1.36) and in older than in younger patients (?30 vs. >50 yrs: OR=0.58), but less likely in patients with high baseline CGI-severity (CGI>4; OR=0.63) or treatment with oral typicals before baseline (OR=0.53). Higher QOL ratings by the patient (SWN>>QLS) were less likely in patients with psychotherapy before baseline (OR=0.54), medication intolerability before baseline (OR=0.53) or patient request of treatment change at baseline (OR=0.64).

The combination of several factors predicted concordant QoL ratings, including male sex, young age, high CGI at baseline, and prior treatment with oral typical antipsychotics.