Schizophrenia: Morbidity and Mortality

Morbidity and Mortality

The economic costs of schizophrenia have been estimated to be six times the costs of myocardial infarction. The WHO has estimated that mental illness accounts for as much as two-fifths of all dis-ability funding in the USA. In the USA, the cost of schizophrenia in 1994 was $44.9 billion and rising. Much of the cost of schizo-phrenia is due to the high morbidity of this chronic illness. Premor-bid deficits, cognitive deficits and negative symptoms account for much of the disability. Also, schizophrenia patients with more se-vere courses may require repeated hospitalizations and may not be capable of maintaining independent living or stable employment.

The mortality rate of schizophrenia is estimated to be twice that of the general population. Approximately 10% of the mortal-ity is secondary to suicide Young male patients with schizophre-nia are most likely to complete suicide attempts, especially early in their illness. Degree of social isolation, agitation, depression, a sense of hopelessness, a history of prior suicide attempts and re-cent loss may be associated with increased risk of suicide among schizophrenia patients. There is also some evidence that an in-creased number of relapses, rehospitalizations and discharges lead to an increased risk of suicide. There have been observa-tions that suicide rates of schizophrenia patients may be increas-ing in the era of shorter hospital stays and community treatment. However, with the advent of the novel antipsychotic medications and especially with clozapine use, it is possible that this risk of suicide may even out or decrease due to their possible protective effects against suicide. Other factors leading to increased mortal-ity rates in schizophrenia patients include an increased incidence of accidents as well as a more frequent association with other medical illnesses (including cardiovascular disease), comorbid substance abuse, a general neglect of health, an increased rate of damaging behaviors such as smoking and poor diet, decreased access to health services and depression.