Perspectives on Treatment Needs in Schizophrenia

Abstract

Schizophrenia is one of the most severe and debilitating major psychiatric diseases, with a yearly prevalence of 0.4–0.8% in the general population (Dohrenwend, 1980; Flekkoy, 1987) and a lifetime risk of 1–1.5% (Regier et al, 1984; Robins et al, 1984). It is the prototype of a severe mental illness, with the capacity to disrupt routine daily functions in all areas of life, but especially work, social relationships, and self-care. Schizophrenia also increases the vulnerability of a patient to physical and other mental disturbances (Koran et al, 1989). Until recently, the clinical course of this disease has been far worse than that of most other psychiatric disorders, thus making it devastating for many individuals and costly to society (McGlashan, 1988). Schizophrenic patients occupy 20–25% of all the beds available for psychiatric in-patient care and account for 40% of all long-stay hospital days (Talbott et al, 1987; Meise et al, 1992). It is not so much the direct costs associated with treatment, but rather the indirect costs, such as those that arise from morbidity and mortality, that place a severe burden on the social economy (Gunderson & Mosher, 1975; Hall et al, 1985; Rice et al, 1992).