The economic burden of schizophrenia spectrum disorders: clinical and functional correlates and predictors of direct costs. A retrospective longitudinal study

Abstract

• Schizophrenia spectrum disorders (SSD) weight substantially on healthcare systems. • Direct healthcare costs were analyzed in a sample of 276 individuals with SSD. • A mean direct cost of 16477.23 (±32856.47) € per patient per year was identified. • Cost predictors were psychosocial functioning, age of onset and symptom severity. • Socially useful activities and negative symptoms outranked other scale items. The economic burden of schizophrenia amounts for 1.5-3 % of healthcare expenses in developed countries, and ∼50 % derives from direct costs: 81 % of these are due to hospitalization, residential facilities and semi-residential facilities. Therefore, a better characterization of variables that influence direct costs represents a relevant issue. A total of 276 individuals with schizophrenia spectrum disorders receiving treatment from the Community Mental Health Centers of Brescia (Italy) were included in the study: for each participant socio-demographic, clinical and functional characteristics were assessed, and data related to the use of services in 2022 (then converted to costs) were collected. Regression analyses were performed to identify predictors of costs. A direct healthcare expenditure of 16477.23 (±32856.47) € per patient per year was identified. The main cost predictor was the PSP total score (p=0.005), followed by age of onset (p=0.020), and PANSS total score (p=0.033). Including PANSS sub-scales scores and PSP single items as potential predictors, the main predictor was the “socially useful activities” PSP item (p=0.002), followed by age of onset (p=0.011), and PANSS negative scale score (p=0.027). Our findings underline the need to implement rehabilitative intervention focused on the improvement of psychosocial functioning and negative symptoms, also to reduce healthcare expenses.

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