Psychological Medicine

Orginal Articles

Subjective utility ratings of neuroleptics in treating schizophrenia*

Stephen E. Finna1 c1, J. Michael Baileya1, Robert T. Schultza1 and Raymond Fabera1

a1 Department of Psychology, University of Texas at Austin; Department of Psychology, Northwestern University; and the Audie L. Murphy Memorial Veterans Hospital and University of Texas Health Science Center at San Antonio, Texas, USA


This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rated the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.


c1 Address for correspondence: Dr Stephen E. Finn, Mezes Hall 330, University of Texas, Austin, TX 78712, USA.


* Parts of this paper were presented at the meeting of the Society of Biological Psychiatry, 7 13 May 1988, Montreal, Canada.