Epidemiology of schizophrenia and its management over 8-years period using real-world data in Spain

Abstract

Background: Real-World Data (RWD) studies provide important insights in disease epidemiology, in real clinical populations, with long follow-up periods. The aim of the present study was to describe the epidemiology of schizophrenia spectrum disorders (SD) during an 8-year period in Spain. Methods: A retrospective cohort of subjects aged 15 to 64 years was followed-up using electronic healthcare databases of the Valencia region (2008-2015). SD cases included outpatient and inpatient settings (ICD 9 codes 295.XX). Prevalence of SD was assessed. Incidence rate (IR) in the subpopulation aged between 15 and 34 years was also provided. Healthcare utilization (HCU) rates, including outpatient, specialists, hospitalizations and antipsychotic dispensations were estimated. Results: The cohort included 3,976,071 subjects; 24,749 of them had a prevalent diagnosis of SD. The overall prevalence for SD was 6.2 per 1000 persons. SD were 76% more prevalent in men than women. IR in the subpopulation aged between 15 and 34 years was 50.25 per 100,000 persons years and was more than 2 times higher for men than for women. 83.4% of the overall outpatient visits from the cohort of patients were related to SD. The 21,095 overall hospitalizations with the SD code resulted in 286,139 days of hospitalization, with a median of 4 days (IQR: 1.6-9.2) per person-year. 93.2% of subjects diagnosed with SD were ever treated with some antipsychotic drug during the study period, and 70% of the patients were ever treated with antipsychotic polypharmacy. Conclusions: This large population-based study using RWD provides novel and recent information SD in a southern European country. The prevalence and IR of SD showed is greater than previously published and higher in men than in women. The fact of having used a large arsenal of electronic data (including outpatient and inpatient) for 8 years may have influenced. SD represents high burden and healthcare utilization. Contrary to guidelines recommendations the majority of patients were ever treated with antipsychotic polypharmacy.

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“…Although we designed our study to start observation from when a patient was diagnosed with schizophrenia and related disorders, our previous findings suggested that this did not always occur (Corrao et al, 2021), probably due to our inability to account for private services. Thus, as the onset of schizophrenia and related disorders is usually less likely to occur after the age of 40, we used a different age range for including newly taken-in-care patients, similar to a recent survey in Spain using HCU to assess the epidemiology of schizophrenia (Orrico-Sánchez et al, 2020). Second, as with any observational study based on HCU databases, a pitfall of our study concerns the lack of clinical data (e.g.…”

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“…Schizophrenia (SCZ) is a serious psychiatric condition associated with hallucinations or delusions coupled with disorganized speech, disorganized thinking, or negative symptoms present for at least 6 months ( Andreasen and Olsen, 1982 ; Orrico-Sánchez et al, 2020 ). Negative symptoms include lack of expression, significant reduction in speech/communication, lack of motivation, and decreased social drive ( American Psychiatric Association, 1994 ; Leo and Regno, 2000 ).…”

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