The cost of relapse and the predictors of relapse in the treatment of schizophrenia

Ascher-Svanum, Haya; Baojin Zhu; Faries, Douglas E.; Salkever, David; Slade, Eric P.; Xiaomei Peng; Conley, Robert R.
January 2010
BMC Psychiatry;2010, Vol. 10, Special section p1
Academic Journal
Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Results: Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels. Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.


Related Articles

  • Relapse and rehospitalisation rates in patients with schizophrenia: effects of second generation antipsychotics. Csernansky, J.G.; Schuchart, E.K.; Csernansky, John G; Schuchart, Emily K // CNS Drugs;2002, Vol. 16 Issue 7, p473 

    Recent studies suggest that the risk of relapse in patients with schizophrenia is approximately 3.5% per month. Predictors of more frequent relapses include poor compliance with antipsychotic drug treatment, severe residual psychopathology, poor insight into the illness and the need for...

  • Growth hormone responses to apomorphine HCl in schizophrenic patients on drug holidays and at relapse. Cleghorn, J. M.; Brown, G. M.; Brown, P. J.; Kaplan, R. D.; Dermer, S. W.; MacCrimmon, D. J.; Milton, J.; Mitton, J // British Journal of Psychiatry;May83, Vol. 142, p482 

    In nine schizophrenic patients on drug holiday, growth hormone (GH) response to apomorphine HCl 0.75 mg (APO) was compared with normal control data. Patients were tested at two month intervals for up to 14 months. Seven patients relapsed, and of these, five had exaggerated GH responses to APO at...

  • The expectation of outcome from maintenance therapy in chronic schizophrenic patients. Johnson, D. A. W.; Johnson, D A // British Journal of Psychiatry;Mar76, Vol. 128, p246 

    The results from a prospective follow-up study of a group of schizophrenic patients suggest that a significant proportion (41 per cent) are likely to relapse during a two-year period despite the prescription of long-acting injectable neuroleptic drugs. Some will relapse because of a failure of...

  • Assessment and Treatment of Early-Stage Schizophrenia. O'Sullivan, Michael // Psychiatric Annals;2015, Vol. 45 Issue 11, p542 

    The article presents a case study of the diagnosis and treatment of early-stage schizophrenia in a 25-year-old man. He participated in multiple elements of the first episode psychosis (FEP) program including young adult group resiliency training, individual therapy and cognitive enhancement...

  • Compliance with treatment and its relevance for the management of schizophrenia. Hofer, Alex; Fleischhacker, W. Wolfgang // Hot Topics in Neurology & Psychiatry;Jun2011, Vol. 4 Issue 11, p7 

    Poor compliance with treatments for schizophrenia limits their effectiveness and results in an increased risk of relapse, a greater likelihood of hospital admission, a longer duration of hospitalization, as well as antipsychotic treatment resistance and development of chronic psychosis. Although...

  • Long-Acting Injectable Antipsychotics in First-Episode Schizophrenia. Parellada, Eduard; Velligan, Dawn I.; Emsley, Robin; Kissling, Werner // Schizophrenia Research & Treatment;2012, p1 

    Long-acting injectable antipsychotics (LAIAs) may improve adherence to treatment and reduce the rate of relapse and rehospitalization in first-episode or recent-onset schizophrenia (e.g., less than 2?years of illness duration). However, despite their potential advantages, LAIAs are underutilised...

  • The Nithsdale schizophrenia surveys. XI: Relatives' expressed emotion. Stability over five years and its relation to relapse. McCreadie, R.G.; Robertson, L.J.; Hall, D.J.; Berry, I. // British Journal of Psychiatry;Mar93, Vol. 162, p393 

    The level of expressed emotion (EE) in 32 relationships between relatives and schizophrenic patients was assessed on three separate occasions over five years. EE was high on all three occasions in 25% of relatives, low on all three in 38%, and fluctuating in 38%; that is, in the majority of...

  • Assessment and Treatment Selection for “Revolving Door” Inpatients with Schizophrenia. Weiden, Peter; Glazer, William // Psychiatric Quarterly;Dec1997, Vol. 68 Issue 4, p377 

    Goals: The goals of this study are 1) to determine causes and patterns of relapse for a cohort of “revolving door” schizophrenia inpatients, and 2) to assess the feasibility of starting a new psychopharmacologic intervention before discharge, either depot therapy or an atypical...

  • First attacks of schizophrenia.  // British Medical Journal;3/19/1977, Vol. 1 Issue 6063, p733 

    Focuses on the prognosis of schizophrenia after first attack. Effect of the absence of agreed definition of schizophrenia in determining prognosis; Vagueness in the criteria for diagnosis; Importance of family and social relationships in causing relapse.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics