Schizophrenia spectrum disorders significantly impact daily functioning, with antipsychotic medications regarded as the gold standard treatment. However, their efficacy is often limited by side effects and adherence rates. Understanding patient perspectives and subjective experiences, particularly regarding oral versus long-acting injectable (LAI) antipsychotics, is crucial for improving medication outcomes and patient-tailored treatments. A systematic review of qualitative studies was conducted following the ENTREQ guidelines. Data were extracted from PubMed, Scopus, and PsycInfo, with thematic synthesis used to identify key themes in patient-reported experiences. Thirty-nine studies (1.477 patients) were included and analyzed, revealing three core themes: (1) perception and experience of medication, (2) social dynamics and influence, and (3) trust and communication with healthcare providers. Side effects and lack of information were often mentioned by patients. While LAI antipsychotics were linked to symptom stability and functional improvements, many patients lacked adequate information about their effects, contributing to adherence difficulties. Stigma and negative beliefs were common across both oral and LAI formulations, thus determining significant barriers to medication adherence. This review emphasizes that patients' experiences with antipsychotic medications are shaped by three key factors: the environment, the therapeutic relationship, and the drug itself. Two critical areas warrant particular attention: psychoeducation and stigma. Bridging psychoeducational gaps and addressing stigma could significantly enhance treatment adherence and outcomes. Additionally, greater emphasis on providing comprehensive and accurate information about antipsychotic treatment options is essential to support patient-centred care and informed decision-making.

Background Patients undergoing antipsychotic treatment for psychiatric disorders may experience challenges in functioning, either stemming from the severity of the illness or from the tolerability issues of prescribed medications. Objectives The aims of this cross-sectional study are to investigate the impact of adverse effects of antipsychotic drugs on patients’ daily life functioning, comparing oral and long-acting injectable (LAI) antipsychotics, and further dividing antipsychotics by receptor-binding profiles based on recently defined data-driven taxonomy. Methods This study involved patients with schizophrenia and bipolar spectrum disorders taking oral or LAI antipsychotics. Disability and functioning levels were assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and the adverse effects of medications were evaluated using the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and its subscales. Results The total sample consisted of 126 participants with a diagnosis of schizophrenia-spectrum or bipolar disorder, and included 54 males and 72 females ranging from 18 to 78 years of age (mean 45.1, standard deviation 14); 78 patients were taking oral antipsychotics and 48 were taking LAI antipsychotics, with subcategories of muscarinic (31), adrenergic/low dopamine (25), serotonergic/dopaminergic (23), dopaminergic (1), LAI muscarinic (15), LAI adrenergic (6), and LAI serotonergic/dopaminergic (25). The UKU total score for adverse effects showed significant correlations with WHODAS total score (ρ = 0.475; p < 0.001). Compared with oral antipsychotics, LAIs showed significantly lower scores in psychological (p = 0.014), autonomic (p = 0.008), other (p = 0.004), and sexual adverse effects (p = 0.008), as well as the UKU total score (p = 0.002). The Kruskal–Wallis test showed a significant difference in adverse effects between LAI and oral muscarinic subgroups, with LAIs having lower scores compared with antipsychotics binding to muscarinic receptors (p = 0.043). Conclusion These findings indicate clinically relevant differences in adverse effects among formulations, warranting further investigation for future observational studies.

Background: Schizophrenia and bipolar disorder significantly impair daily functioning and quality of life. Effective treatment monitoring requires tools assessing both clinical symptoms and everyday impairment. Aim: This cross-sectional study explored relationships between symptoms, side effects, and functioning using clinician-rated and patient-reported measures. We examined whether the Glasgow Antipsychotic Side-Effect Scale (GASS), a patient-reported outcome measure (PROM), is associated with disability and quality of life comparably to the clinician-administered Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale. Methods: We recruited 100 individuals with schizophrenia spectrum or bipolar disorders receiving antipsychotic treatment. Linear regressions and network analyses were conducted. Linear regressions assessed the association between side effects, disability (World Health Organization Disability Assessment Schedule, WHODAS) and quality of life (EuroQol 5-Dimension scale, EQ-5D). Network analyses were conducted to explore the interplay between side effects, disability, quality of life and symptoms, the latter assessed using the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), and Montgomery–Åsberg Depression Rating Scale (MADRS). Results: Side effects assessed with GASS and UKU significantly impacted disability (GASS: p < .001, 95% CI [0.274; 0.635]; UKU: p < .001, 95% CI [0.313; 1.021]) and reduced quality of life (GASS: p < .001, 95% CI [-1.391; -0.511]; UKU: p < .001, 95% CI [-3.176; -1.668]). Network analysis identified depressive symptoms as central in the UKU network and autonomic side effects as central in the GASS network. Conclusion: GASS total and subgroup scores showed comparable associations with disability and quality of life as UKU. Integrating both perspectives enables comprehensive monitoring and patient-centred care.

Antipsychotic dose reduction and discontinuation are increasingly discussed in the management of psychotic disorders, yet clinical decisions remain challenging and evidence on lived experiences is fragmented. This systematic review and meta-synthesis aimed to synthesize qualitative evidence on subjective experiences of antipsychotic dose reduction and discontinuation among people with psychotic disorders, clinicians, and caregivers. A systematic search was performed on PubMed, Scopus, and PsycINFO. Peer-reviewed qualitative studies exploring subjective experiences with antipsychotic dose reduction and/or discontinuation in subjects with affective and non-affective psychotic disorders were included. Findings were integrated using thematic synthesis. A total of 13 studies were included. Eight studies focused on patients ( N = 431), three on clinicians ( N = 86), and two on caregivers ( N = 26). From subjects’ lived experiences, adverse effects were frequently reported as a driver for considering dose reduction, while concerns about relapse and the effort required to maintain stability contributed to ambivalent or cautious attitudes. Caregivers often reported unfavorable views, expressing fear of symptom recurrence, emotional distress, and risks to relational safety. Clinicians highlighted limited evidence and insufficient resources to support safe, long-term tapering and described uncertainty intensified by negative prior experiences and concerns about professional accountability in the event of relapse. Antipsychotic dose reduction and discontinuation are experienced as complex, preference-sensitive processes shaped by competing priorities and high perceived risks. The findings support the need for triadic shared decision-making that includes caregivers and for the development of structured, case-specific tapering protocols supported by adequate clinical resources and long-term monitoring.

Background: Adolescence and emerging adulthood are periods of heightened risk for the onset of psychopathology. Emotion dysregulation (ED), impulsiveness, and rumination are transdiagnostic processes implicated across symptom domains, but their relative contributions in clinical youth samples remain unclear. This study examined these three self-regulatory processes simultaneously in first-time help-seeking adolescents and young adults, addressing their differential associations with psychopathological symptom dimensions at an early stage of clinical contact. Methods: We conducted a retrospective observational study with a cross-sectional design in outpatients aged 16–25 years presenting for a first-time psychiatric outpatient consultation at a university hospital in Catania, Italy. Participants completed self-report measures of rumination (RRS), impulsiveness (BIS-11), ED (DERS), and psychopathological symptoms (SCL-90-R). Associations were examined using Spearman’s and partial correlations. Multivariate multiple regression, followed by outcome-specific multiple linear regression models, assessed the relative associations of rumination, ED, and impulsiveness across symptom dimensions. Results: Rumination showed the broadest pattern of unique associations, with FDR-significant associations with eight SCL-90-R domains; the largest coefficient was observed for depression (B = 0.053, 95% CI [0.042, 0.064]). ED was associated with obsessive–compulsive symptoms, depression, anxiety, anger–hostility, and phobic anxiety. Impulsiveness showed more limited associations, remaining significant for anger–hostility and psychoticism. Conclusions: Findings are consistent with a transdiagnostic framework in which rumination and ED relate to multiple symptom dimensions, whereas impulsiveness shows more domain-specific associations. Because the study was cross-sectional and based on self-report measures, these associations should be tested in larger longitudinal and multimethod studies.