Measuring the costs of schizophrenia. Implications for the post-institutional era in the US.

摘要: Schizophrenia is a stress-related biomedical condition of the brain, characterised by unusual internal experiences, severe and often persistent functional disability socially inappropriate behaviour. It estimated that schizophrenia affects approximately 1% all adults worldwide. Young are especially vulnerable. an illness with profound economic impact on patients, their families society at large. Before 1950s, most patients were admitted to hospital for long inpatient stays. Keeping patient in institutional setting was psychiatry could offer, because there little active treatment available. After World War II, following introduction chlorpromazine 1954, offered increasingly outpatient settings. At present, more than 90% individuals will receive healthcare services facilities, supplemented brief treatment. The trend toward community-based care continues into 1990s, supported part recent pharmacotherapeutic developments making new generation drug options Clozapine, widely used these drugs, has been subject several studies compared its costs those conventional treatments. These early suggest further reductions cost possible near future. same time, despite increasing availability effective settings, shift resources from community not occur as quickly some might wish. Delays transformation systems caused political interest groups sheer inertia infrastructure left over era care. factors must be taken account estimating during next decade. aim this review provide clinical picture schizophrenia, emphasising features contribute illness. We define quantify direct indirect illness, discuss implications psychosocial treatments, critique strategies measuring efficacy difficulties related transition US also reviewed.