Schizophrenia is a chronic disease associated with a significant and long-lasting health, social, and financial burden, not only for patients but also for families, other caregivers, and the wider society. Many national and local studies have sought to estimate the societal burden of the illness--or some components of it--in monetary terms. Findings vary. We systematically reviewed the literature to locate all existing international estimates to date. Sixty-two relevant studies were found and summarized. Within- and between-country differences were analyzed descriptively. Despite the wide diversity of data sets and methods applied, all cost-of-illness estimates highlight the heavy societal burden of schizophrenia. Such information helps us to understand the health, health care, economic, and policy importance of schizophrenia, and to better interpret and explain the large within- and across-country differences that exist.

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Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.

Objectives We describe the development of a five-session psychoeducational treatment, Facilitated Integrated Mood Management (FIMM), which contains many of the core elements of longer evidence-based psychosocial treatments for bipolar disorder. FIMM incorporated a novel mood monitoring program based on mobile phone technology. Methods Adult patients with bipolar I and II disorders (N = 19) received six sessions (Pilot I: n = 14) or five sessions (Pilot II: n = 5) of FIMM with pharmacotherapy. Treatment facilitators were novice counselors who were trained in a three-day workshop and supervised for six months. FIMM sessions focused on identifying early signs of recurrence, maintaining regular daily and nightly routines, rehearsing mood management strategies, maintaining adherence to medications, and education about substance abuse. Patients sent daily text messages or e-mails containing ratings of their mood and sleep and weekly messages containing self-ratings on the Quick Inventory of Depressive Symptomatology (QIDS) and the Altman Self Rating Mania Scale (ASRM). Patients also completed a weekly mood management strategies questionnaire. Results Of the 19 patients, 17 (89.5%) completed FIMM in an average of 9.2 ± 3.4 weeks (Pilot I) and 7.6 ± 0.9 weeks (Pilot II). Patients reported stable moods on the QIDS and ASRM over a 120-day period, and on average responded to 81% of the daily message prompts and 88% of the weekly QIDS and ASRM prompts. Facilitators maintained high levels of fidelity to the FIMM manual. Patients’ knowledge of mood management strategies increased significantly between the first and last weeks of treatment. Conclusions Patients with bipolar disorder can be engaged in a short program of facilitated mood management. The effects of FIMM on the course of bipolar disorder await evaluation in randomized trials. The program may be a useful adjunct to pharmacotherapy in community centers that cannot routinely administer full courses of psychosocial treatment.

Medical Research Council.

The limited available evidence reflects a general under-detection and under-treatment of eating disorders. Although both cost-of-illness studies may significantly underestimate the costs of eating disorders because of important omitted cost items, other evidence suggests that the economic burden is likely to be substantial. Comprehensive data on the resource use of patients with eating disorders are urgently needed for better estimations, and to be able to determine cost-effective treatment options.