The economic burden of schizophrenia in Canada in 2004

Goeree, Ron; Farahati, Farah; Burke, Natasha; Blackhouse, Gord; O’Reilly, Daria; Pyne, Jeff; Tarride, Jean‐Éric

doi:10.1185/030079905x75087

Cited by 131 publications

(100 citation statements)

References 45 publications

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“…Reduced cognitive function is considered to be the most debilitating aspect of schizophrenia as the severity of these symptoms directly relates to the patient's quality of life and current pharmaceutical interventions provide minimal improvement (Elvevåg and Goldberg, 2000;Goldman-Rakic et al, 2004;Goeree et al, 2005;van Os and Kapur, 2009). Nonhuman primates also show similar cognitive deficits following systemic subanesthetic doses of ketamine as patients with schizophrenia in a number of behavioral tasks (Condy et al, 2005;Stoet and Snyder, 2006).…”

Section: Introductionmentioning

confidence: 99%

NMDA Antagonist Ketamine Reduces Task Selectivity in Macaque Dorsolateral Prefrontal Neurons and Impairs Performance of Randomly Interleaved Prosaccades and Antisaccades

Skoblenick¹,

Everling

2012

J. Neurosci.

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Ketamine, an NMDA receptor antagonist, has been shown to induce behavioral abnormalities in humans that mimic the positive, negative, and most importantly cognitive deficits observed in schizophrenia. Similar cognitive deficits have been observed in nonhuman primates after a subanesthetic dose of ketamine, including an impairment in their ability to perform the antisaccade task, which requires the suppression of a prosaccade toward a flashed stimulus and the generation of a saccade in the opposite direction. The neural basis underlying these cognitive impairments remains unknown. Here, we recorded single-neuron activity in the lateral prefrontal cortex of macaque monkeys before and after the administration of subanesthetic doses of ketamine during the performance of randomly interleaved prosaccade and antisaccade trials. Ketamine impeded the monkeys' ability to maintain and apply the correct task rule and increased reaction times of prosaccades and antisaccades. These behavioral changes were associated with an overall increase in activity of PFC neurons and a reduction in their task selectivity. Our results suggest that the mechanism underlying ketamine-induced cognitive abnormalities may be the nonspecific increase in PFC activity and the associated reduction of task selectivity.

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Section: Introductionmentioning

confidence: 99%

NMDA Antagonist Ketamine Reduces Task Selectivity in Macaque Dorsolateral Prefrontal Neurons and Impairs Performance of Randomly Interleaved Prosaccades and Antisaccades

Skoblenick¹,

Everling

2012

J. Neurosci.

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“…1,2 It is associated with a tremendous personal, social, and economic burden. 3 Most of its burden is due to the functional disabilities from which patients with schizophrenia suffer.…”

Section: Cognition Fonction Et Incapacité Chez Des Patients Souffranmentioning

confidence: 99%

Cognition, Function, and Disability in Patients with Schizophrenia: A Review of Longitudinal Studies

2014

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This paper aims to review longitudinal studies assessing the impact of cognition on function in patients with schizophrenia. PubMed and Scholars Portal were searched using search terms related to schizophrenia, cognition, function, and longitudinal studies. Some functional abilities have been studied more than others. Some studies suggest that the impact of cognition on function depends on the severity of baseline cognitive deficits. Other studies suggest that the impact of cognition on function depend on what phase of the illness the patient is in or what stage in that particular function the patient is involved in. Finally, few studies assessed interactions between cognition and other aspects of schizophrenia in predicting function, such as functional capacity, insight, motivation, and negative symptoms. More longitudinal and comprehensive studies are needed. A focus on community living is of high public significance as patients with schizophrenia continue to grow old. Future studies should also focus on the longitudinal interactions between cognition and other dimensions of schizophrenia as well as on the biological factors that underlie these interactions. W W W Cognition, fonction et incapacité chez des patients souffrant de schizophrénie : une revue des études longitudinalesCet article vise à examiner les études longitudinales évaluant l'effet de la cognition sur la fonction des patients souffrant de schizophrénie. Des recherches ont été effectuées dans PubMed et Scholars Portal à l'aide de mots clés liés à la schizophrénie, la cognition, la fonction, et les études longitudinales. Certaines capacités fonctionnelles ont été étudiées plus que d'autres. Des études suggèrent que l'effet de la cognition sur la fonction dépend de la gravité des déficits cognitifs au départ. D'autres études font valoir que l'effet de la cognition sur la fonction dépend de la phase de la maladie ou du stade de cette fonction où se situe le patient. Enfin, peu d'études ont évalué les interactions entre cognition et autres aspects de la schizophrénie pour prédire la fonction, comme la capacité fonctionnelle, l'intuition, la motivation, et les symptômes négatifs. Il faut plus d'études longitudinales et exhaustives. Mettre l'accent sur la vie dans la communauté est d'une grande importance publique car les patients souffrant de schizophrénie continuent de vieillir. Les futures études devraient aussi se pencher sur les interactions longitudinales entre la cognition et d'autres dimensions de la schizophrénie, ainsi que sur les facteurs biologiques qui sous-tendent ces interactions.S chizophrenia affects more than 24 million adults, worldwide, and about a quarter of a million in Canada.

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“…5 The English study estimated total schizophrenia-related costs in 2004 and 2005 were £ 6.7 billion, £ 2 billion in direct and £ 4.7 billion in indirect costs.…”

mentioning

confidence: 99%

Direct medical costs associated with schizophrenia relapses in health care services in the city of São Paulo

2011

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OBJECTIVE:To assess direct medical costs associated with schizophrenia relapses in mental health services. METHODS:The study was conducted in three health facilities in the city of São Paulo: a public state hospital; a Brazilian National Health System (SUS)-contracted hospital; and a community mental health center. Medical records of 90 patients with schizophrenia who received care in 2006 were reviewed. Information on inpatient expenditures was collected and used for cost estimates. RESULTS:Mean direct medical cost of schizophrenia relapses per patient was US$ 4,083.50 (R$ 8,167.58) in the public state hospital; US$ 2,302.76 (R$ 4,605.46) in the community mental health center; and US$ 1,198.50 (R$ 2,397.74) in the SUS-affi liated hospital. The main component was daily inpatient room rates (87% -98%). Medication costs varied depending on the use of typical or atypical antipsychotic drugs. Atypical antipsychotic drugs were more often used in the community mental health center. CONCLUSIONS:Costs associated with schizophrenia relapses support investments in antipsychotic drugs and strategies to reduce disease relapse and the need for mental health inpatient services. Treating patients in a community mental health center was associated with medium costs and added the benefi t of not depriving these patients from family life. The mean incidence of schizophrenia is one to two cases per 10,000 people per year and its prevalence is 0.7% in adults worldwide. 17 In Brazil, the literature shows inconsistent data, but schizophrenia prevalence is likely higher than that reported, and close to that reported in a meta-analysis by McGrath et al. 18,23 Schizophrenia has a chronic course with an estimated improvement of 40% after fi ve to six years of follow-up. DESCRIPTORS: 7To assess schizophrenia burden, reviewed 62 studies and found three major studies on costs associated to schizophrenia from the United States, Canada, and England. 10 The US study estimated a total cost of US$ 62.7 billion in 2002, of which US$ 22.7 billion in direct costs; US$ 7.6 billion in non-medical direct costs and US$ 32.4 billion in indirect costs. 27The Canadian study estimated a cost of schizophrenia of C$ 6.5 billion in 2004, of which C$ 2.02 billion in direct medical and non-medical costs and C$ 4.83 billion in indirect costs. 5 The English study estimated total schizophrenia-related costs in 2004 and 2005 were £ 6.7 billion, £ 2 billion in direct and £ 4.7 billion in indirect costs.14 In all three studies the main component of indirect cost was loss of productivity. According to the Global Burden of Disease Assessment, schizophrenia causes a high degree of disability and accounts for 1.1% of all disability-adjusted life years (DALYs), and for 2.8% of all years lived with disability (YLDs). CONCLUSÕES:O investimento em medicações antipsicóticas e em estratégias que diminuam a recaída e a necessidade de diárias nos serviços, especialmente hospitalares, são justifi cáveis pela proporção dos custos que estas representam. Tratar a recaí...

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The economic burden of schizophrenia in Canada in 2004

Cited by 131 publications

References 45 publications

NMDA Antagonist Ketamine Reduces Task Selectivity in Macaque Dorsolateral Prefrontal Neurons and Impairs Performance of Randomly Interleaved Prosaccades and Antisaccades

NMDA Antagonist Ketamine Reduces Task Selectivity in Macaque Dorsolateral Prefrontal Neurons and Impairs Performance of Randomly Interleaved Prosaccades and Antisaccades

Cognition, Function, and Disability in Patients with Schizophrenia: A Review of Longitudinal Studies

Direct medical costs associated with schizophrenia relapses in health care services in the city of São Paulo

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