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