The personal, societal, and economic burden of schizophrenia in the People's Republic of China: implications for antipsychotic therapy

Abstract

BackgroundThis article describes the personal, societal, and economic burden attributable to schizophrenia in the People’s Republic of China and highlights the potential for effective outpatient treatment to reduce this burden given recent changes in the Chinese health care system. The importance of effective antipsychotic therapy in reducing the burden of schizophrenia is also examined.MethodsPublished research on the burden, disability, management, and economic costs of schizophrenia in the People’s Republic of China was examined in the context of the larger body of global research. Research written in English or Chinese and published before June 2012 was identified using PubMed, CNKI, and Wanfang Med database searches. The contribution of effective antipsychotic therapy in reducing the risk for relapse and hospitalization and improving patients’ functioning is described.ResultsSchizophrenia imposes a substantial burden on Chinese society, with indirect costs accounting for the majority of the total cost. Functional impairment is high, leading to lost wages and work impairment. In the People’s Republic of China, schizophrenia is the most common diagnosis among hospitalized psychiatric patients. Ongoing changes in the Chinese health care system may reduce some barriers to effective relapse prevention in schizophrenia and potentially reduce hospitalizations. The use of antipsychotics for acute episodes and maintenance treatment has been shown to decrease symptom severity and reduce the risk for relapse and hospitalization. However, discontinuing antipsychotic medication appears common and is a strong predictor of relapse. Cost-effectiveness research in the People’s Republic of China is needed to examine the potential gains from improved outpatient antipsychotic treatment.ConclusionSchizophrenia is a very costly mental illness in terms of personal, economic, and societal burden, both in the People’s Republic of China and globally. When treated effectively, patients tend to persist longer with antipsychotic treatment, have fewer costly relapses, and have improved functioning. Further research examining the long-term effects of reducing barriers to effective treatments on the societal burden of schizophrenia in the People’s Republic of China is needed.

Olanzapine in Chinese patients with schizophrenia or bipolar disorder: a systematic literature review

“…These factors can also assist clinicians in the early identification of patients who may be appropriate candidates for weight management programs 69. Such programs may lower the risk of clinically significant weight gain during treatment with olanzapine and also provide additional clinical and functional benefits, including better treatment response and reduced impairment in work activities 4. Regarding the changes in metabolic parameters, the results observed in Chinese populations have been noted in numerous studies in non-Chinese populations 110,113.…”

“…A large-scale review estimated that the 1-month prevalence of any mental disorder among mainland Chinese is 17.5%, including a prevalence of mood disorders of 6.1% and a prevalence of psychotic disorders of 1.0% 2. In terms of addressing the challenge of chronic psychotic disorders, evidence from Chinese and non-Chinese populations suggests that effective treatment of psychotic disorders improves patient outcomes 3,4. However, synthesis of data from individual trials of antipsychotic agents to provide clinically useful recommendations for clinicians has mainly focused on non-Chinese populations 5…”

Factors associated with early response to olanzapine and clinical and functional outcomes of early responders treated for schizophrenia in the People’s Republic of China

“…The personal, economic, and societal burden of schizophrenia is high, and when treated effectively, patients tend to persist longer with antipsychotic treatment, have fewer costly relapses, and have improved functioning 53. A recent analysis in Tianjin, People’s Republic of China, reported that patients with inpatient costs had almost ten times the cost of those without inpatient treatment 54.…”

Hospitalization of schizophrenic patients in the public health system of Minas Gerais, Brazil

“…It is costly to society due to its long course, high occurrence of comorbidities, necessity of hospitalizations and lack of a universally effective pharmacological treatment. Its prevalence is estimated to be between 0.3 and 1% worldwide (Mari & Leitão, 2000;Daltio et al, 2007;Messias et al, 2007;Montgomery et al, 2013). The main objective of the psychiatric hospitalization is to intervene in crisis and to control severely ill patients, ensuring their safety and of others patients (Marcolino, 2007).…”