Download schizophrenia: a serious, chronic brain disease

SCHIZOPHRENIA: A SERIOUS, CHRONIC BRAIN DISEASE
Schizophrenia Facts
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Schizophrenia is a chronic brain disorder characterized by a disruption of thought processes that can cause delusions and hallucinations,1 and affects about 2.4 million
Americans2,3 and 24 million people worldwide.4 Schizophrenia often becomes apparent in late adolescence or early adulthood, but the signs and symptoms vary from person
to person. Initial signs can include isolating oneself, sleep problems, and irritability. 1
While experts are not entirely clear on the cause of schizophrenia, they believe the disease is influenced by several factors, including genetics, the environment and a possible
imbalance in chemical reactions of the brain.1
Patients are at risk for relapse, which is a re-emergence or worsening of psychotic symptoms.5 Certain criteria often are used to define relapse, including aggravation
of psychotic symptoms and hospital admission.6,7
Common contributors to disease relapse include substance abuse, stressful life events, and poor adherence to medication.8
Recurring relapses may result in decreased functioning, increased morbidity, and progression of the illness.5
The Significant Personal and Social Costs of Schizophrenia
Employment
Increased Healthcare Costs
At any given time, the vast majority of
people with schizophrenia – 73% to
89% – are not employed. Of those who
are employed, many work in noncompetitive employment situations (e.g.,
do not compete with applicants from the
general public) or work part-time.9
In 2002, the cost of schizophrenia to
the U.S. healthcare system was
estimated to be $62.7 billion.11
 Direct costs estimated at $30.3
billion included expenditures
for hospital and nursing home
care, physician and other
professional services and
drugs, among other expenses.
 Indirect costs estimated at
$32.4 billion included lost
productivity due to morbidity
and premature mortality and
legal encounters.
Hospitalization
As treatment adherence in schizophrenia
patients decreases, the risk of rehospitalization goes up. In one data
review study, even a 1- to 10-day
maximum gap in treatment in one year
nearly doubled patients' risk of
hospitalization (from approx. 6% to
approx.12%, OR=1.98, p=0.004).5, 10
Increased Morbidity &
Mortality
In a review of multiple studies, it
was calculated that the mortality rate
for people with schizophrenia is 1.6
times greater than in a general
population of similar age and gender,
and the risk of suicide is 9 times
greater.12
Unfortunately, suicide is one of the
leading causes of premature death
among people with schizophrenia,
with an estimated 10 to 13% taking
their lives and approximately 40%
attempting suicide at least once.13
See References on Reverse Side
Community Impact
Based on a review of multiple
studies, the average rate of
schizophrenia among the homeless
population is about 11% .14
Substance abuse is common among
patients with schizophrenia, with
reports of lifetime abuse estimated to
be as high as 47% and approximately
33% of patients with an alcohol
dependence disorder.8
Individuals with schizophrenia may
have a higher risk of encounters with
the criminal justice system than the
general population. In one
retrospective study, about half (46%)
of participants reported at least one
encounter with the criminal justice
system.15
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National Institute of Mental Health (NIMH). Schizophrenia Booklet (2009). Available at http://www.nimh.nih.gov/health/publications/schizophrenia/schizophrenia-booket2009.pdf. Accessed November 1, 2012.
National Institutes of Mental Health (NIMH). The Numbers Count: Mental Disorders in America. Available at http://www.nimh.nih.gov/health/publications/the-numbers-countmental-disorders-in-america/index.shtml. Accessed November 1, 2012.
Regier, D et al. The de Facto US Mental and Addictive Disorder Service System. Arch Gen Psychiatry, 1993; 50: 85-94.
World Health Organization (WHO). Schizophrenia Fact Sheet (2010). Available at http://www.who.int/mental_health/management/schizophrenia/en/. Accessed November 1,
2012.
Lieberman JA et al. The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches. Biol Psychiatry, 2001; 50(11): 884-897.
Almond, S et al. Relapse in schizophrenia: costs, clinical outcomes and quality of life. British Journal of Psychiatry, 2004;184: 346-351
Lader, M. What is relapse in schizophrenia? International Clinical Psychopharmacology, 1995, 5-9.
Kazadi, NJB et al. Factors associated with relapse in schizophrenia. South African Journal of Psychiatry. 2008; 14(2): 52-62.
Slade E et al. Symptom effects on employment in a structural model of mental illness and treatment: Analysis of patients with schizophrenia. Jour Mental Health Policy Econ,
2001; 4: 25-34
Weiden PJ et al. Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv, 2004; 55: 886-891.
E.Q. W et al. The Economic Burden of Schizophrenia in the United States in 2002. Journal of Clinical Psychiatry, 2005; 66(9): 1122-1129.
Knapp M et al. The Global Costs of Schizophrenia. Oxford Journal, 2004; 30(2): 279-293
Nieto G et al. Homeless Mentally Ill Persons: A bibliography review. International Journal of Psychosocial Rehabilitation, 2008; 12(2): 1-25.
Folsom, D and Jeste, D. Schizophrenia in homeless persons: A systematic review of the literature. Acta Psychiatrica Scandinavia, 2002; 105(6): 404-413.
Ascher-Svanum H et al. Involvement in the US criminal justice system and cost implications for persons treated for schizophrenia. BMC Psychiatry, 2010; 10(11): 1-10.
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February 2013
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