Prevalence, Employment Rate, and Cost of Schizophrenia in a High-Income Welfare Society: A Population-Based Study Using Comprehensive Health and Welfare Registers

Abstract

Schizophrenia is associated with recurrent hospitalizations, need for long-term community support, poor social functioning, and low employment rates. Despite the wideranging financial and social burdens associated with the illness, there is great uncertainty regarding prevalence, employment rates, and the societal costs of schizophrenia. The current study investigates 12-month prevalence of patients treated for schizophrenia, employment rates, and cost of schizophrenia using a population-based top-down approach. Data were obtained from comprehensive and mandatory health and welfare registers in Norway. We identified a 12-month prevalence of 0.17% for the entire population. The employment rate among working-age individuals was 10.24%. The societal costs for the 12-month period were USD 890 million. The average cost per individual with schizophrenia was USD 106 thousand. Inpatient care and lost productivity due to high unemployment represented 33% and 29%, respectively, of the total costs. The use of mandatory health and welfare registers enabled a unique and informative analysis on true population-based datasets.

Understanding the direct and indirect costs of a first episode of psychosis program: Insights from PAFIP of Cantabria, Spain, during the first year of intervention

“…The positive impacts of EIPS should also be measured in terms of reduction of unemployment and lost life opportunities; more people paying taxes as a result of completing education and being in employment; and, potentially, a reduction in the costs of managing avoidable physical health problems. Weight gain has become a major concern in the early treatment of psychosis, because it is often associated with poor treatment adherence and clinical outcomes, as well as a reduced quality of life, social stigma, and greater morbidity and mortality (Cocchi et al, ; Evensen et al, ; Liffick et al, ; McCrone et al, ). During our first year of intervention, only 11.46% had mild metabolic syndrome (see Table ).…”

“…The first psychotic breakdown is usually seen in adolescence or in early adulthood. The rate of smoking, obesity, arterial hypertension, and dyslipidemia has been found to be about twice as high in these patients as in a reference population (Evensen et al, 2016). Moreover, high rates of suicide attempts, violence, and criminal problems have been described (Wise, 2014;Witt, Hawton, & Fazel, 2014).…”

Schizophrenia and comorbid sleep disorders

“…[2] The disorder is characterized by positive symptoms, such as hallucinations and delusions, [3] negative symptoms, such as impaired emotional functioning and behavioral disruptions (e.g. flat affect, difficulty in starting activities and completing them, etc.…”

Region‐specific insular volumetric decreases in drug‐naive, first‐episode schizophrenia and their unaffected siblings

“…Schizophrenia is a medical condition that affects about 1% of the general population (Evensen et al, ). Meta‐analyses and longitudinal studies suggest that anatomical changes progress from the early stage of schizophrenia (Andreasen et al, ; Ding et al, ; Haijma et al, ; Olabi et al, ).…”