Functional outcome in schizophrenia: a comparative cross-sectional study on first versus second generation antipsychotics

Aim. The purpose of this study was to compare outpatients with stable schizophrenia who were treated with either first or second generation antipsychotics in terms of executive functions, social functioning and quality of life. Methods. One-hundred and sixty-eight consecutive outpatients with stable schizophrenia were enrolled in a cross-sectional study. At the time of assessment all patients were receiving antipsychotic medication with first (FGAs) or second generation antipsychotics (SGAs). Executive functions were evaluated by the Wisconsin Card Sorting Test (WCST). We adopted the Global Assessment of Functioning (GAF), in order to assess psychological, social and occupational functioning, and the Quality of Life Scale (QLS), to evaluate patients' quality of life. The one-way analysis of variance (one-way ANOVA) was used to compare the two treatment groups with respect to all variables. Results. Sixty-seven patients (40%) were on treatment with FGAs, while 101 patients (60%) were treated with SGAs. Patients treated with SGAs showed better results at WCST, in particular a significantly higher number of completed categories (p=0.009) and a lower percentage of perseverative errors (p=0.001). The subpopulation on SGAs treatment had significantly higher scores at the GAF scale (p=0.004) and at subscale of the QLS evaluating the instrumental role of patients (p=0.043). Discussion. The results of our study suggest that patients treated with SGAs present better outcomes in terms of neurocognition, social functioning and working skills.