Schizophrenia In Spain Research Articles

Clinical and treatment features of patients with schizophrenia in Spain: ACE 2004 study

Methods:Six hundred psychiatrists from private and public Spanish clinics registered the first four patients with schizophrenia seen at their offices during 2004. Sociodemographic characteristics, diagnostic criteria, clinical features, and therapy patterns, including adherence to treatment, were recorded.Results:A total of 2,154 patients were included in the study (86% ≤50 years old; 69% males; 79% unmarried), half of them had elementary school studies only while a 28% had a university degree. Male to female significant differences were observed regarding patterns of cigarette, alcohol, and illegal substance comsumption. A 69% of patients had paranoid schizophrenia, 13% presented with residual schizophrenia, and the remaining 18% had other types. The paranoid and hebephrenic types were the predominant types seen in patients ≤50 years old, while residual schizophrenia was most frequently seen in patients >50. When admitted into the study, 10% of patients were in an acute phase, 19% showed active symptoms, and the remaining 71% showed a stable disorder. Antipsychotic medications more frequently prescribed before enrolment were risperidone (29%), olanzapine (19%), and clozapine, quietapine, amisulpiride and haloperidol (7% each). The most common non-pharmacologic therapy prescribed to patients before entering the study was occupational therapy.Conclusions:Patients included in this observational study were predominantly males <50 year old who presented with paranoid schizophrenia. Almost all patients had received antipsychotic medication before entering the study, mainly risperidone and olanzapine.

Cost-Effectiveness Analysis of Ziprasidone versus Haloperidol in??Sequential Intramuscular/Oral Treatment of Exacerbation of Schizophrenia

This study aimed to assess the cost effectiveness of ziprasidone versus haloperidol in sequential intramuscular (IM)/oral treatment of patients with exacerbation of schizophrenia in Spain. A cost-effectiveness analysis from the hospital perspective was performed. Length of stay, study medication and use of concomitant drugs were calculated using data from the ZIMO trial. The effectiveness of treatment was determined by the percentage of responders (reduction in baseline Brief Psychiatric Rating Scale [BPRS] negative symptoms subscale >or=30%). Economic assessment included estimation of mean (95% CI) total costs, cost per responder and the incremental cost-effectiveness ratio (ICER) per additional responder. The economic uncertainty level was controlled by resampling and calculation of cost-effectiveness acceptability curves. A total of 325 patients (ziprasidone n = 255, haloperidol n = 70) were included in this economic subanalysis. Ziprasidone showed a significantly higher responder rate compared with haloperidol (71% vs 56%, respectively; p = 0.023). Mean total costs were euro3582 (95% CI 3226, 3937) for ziprasidone and euro2953 (95% CI 2471, 3436) for haloperidol (p = 0.039), mainly due to a higher ziprasidone acquisition cost. However, costs per responder were lower with ziprasidone (euro5045 [95% CI 4211, 6020]) than with haloperidol (euro5302 [95% CI 3666, 7791], with a cost per additional responder (ICER) for ziprasidone of euro4095 (95% CI -130, 22 231). The acceptability curve showed an ICER cut-off value of euro13 891 at the 95% cost-effectiveness probability level for >or=30% reduction in BPRS negative symptoms. Compared with haloperidol, ziprasidone was significantly better at controlling psychotic negative symptoms in acute psychoses. The extra cost of ziprasidone was offset by a higher effectiveness rate, yielding a lower cost per responder. In light of the social benefit (less family burden and greater restoration of productivity), the incremental cost per additional responder with sequential IM/oral ziprasidone should be considered cost effective in patients with exacerbation of schizophrenia in Spain.

Cost‐effectiveness of different clinical interventions for reducing the burden of schizophrenia in Spain

To estimate the cost-effectiveness of interventions for reducing the burden of schizophrenia in Spain. The study examined the cost-effectiveness of seven different types of clinical interventions at the level of Spanish population: i) current situation; ii) older antipsychotics alone; iii) new antipsychotics alone (risperidone); iv) older antipsychotics plus psychosocial treatment; v) new antipsychotics plus psychosocial treatment; vi) older antipsychotics plus case management and psychosocial treatment; vii) new antipsychotics plus case management and psychosocial treatment. Interventions based on the combination of haloperidol with psychosocial treatment or psychosocial treatment plus case management proved to be the most efficient strategies. The relatively modest additional cost of concurrent psychosocial treatment has significant health gains, thereby making such a combined strategy for schizophrenia more cost-effective than pharmacology alone.

Assessment of service use patterns in out‐patients with schizophrenia: a Spanish study

The objective is to describe and characterize patterns of service use by out-patients with schizophrenia in Spain. A representative treated prevalence sample of cases with schizophrenia was selected from four Spanish health areas. The evaluation included health service use, clinical severity, functioning and disability. Statistical analysis was based on hierarchical clustering methods. A total of 356 patients were included in the analysis. Five patterns of health service use were defined: heavy out-patient mental health users; mental health and general health service users; heavy hospital service users; nursing service users; low users of mental health services. Patients in each group showed differences in clinical and disability status. Patterns of health service use showed consistency, but also variability, among the geographical areas. Development and organization of mental health services should take into account the combinations of services patients most frequently use.

The costs of schizophrenia in Spain

This study estimated the economic impact of schizophrenia-related direct costs (medical and nonmedical costs) in Spain. Direct medical costs (hospitalizations, outpatient consultations, drug costs) and direct nonmedical costs (costs of informal care) were estimated based on prevalence costs for 2002. The total costs of schizophrenia were estimated at euro 1,970.8 million; direct medical costs accounted for 53% and informal care costs 47%. Despite having implemented a conservative approach, the health care costs associated with schizophrenia account for 2.7% of total public health care expenditure in Spain. The sum of medical and nonmedical costs give us a better definition of the magnitude of the problem in Spain as well as contributing to helping make the debate on this issue more transparent.

Estimating the prevalence of schizophrenia in Spain using a disease model

There are two main sources of information on the epidemiology of schizophrenia: prevalence and incidence studies. Prevalence rates can be estimated from incidence figures, and vice versa. The present article aims to provide an estimate of the prevalence of schizophrenia in Spain, calculated from epidemiological and demographic data, using a disease model of schizophrenia which applies the specific methodology of the WHO Global Burden of Disease project. Our model assumes a causal relationship between incidence and prevalence, but takes into account other competing risk factors of mortality; this approach is more realistic than one assuming a simple linear relationship between both parameters. Our findings indicate an estimated mean prevalence of 3.0 per 1000 inhabitants per year for men, but slightly lower for women: 2.86 per 1000. Our model enables us to compare incidence figures with those provided by prevalence studies and obtain accurate estimates of the distribution of schizophrenia in the general population, which can be used to better identify treatment needs and the consequent allocation of resources.

The programme against stigma and discrimination because of schizophrenia in Spain

The programme against stigma and discrimination because of schizophrenia in Spain

ISO2.01 Fighting stigmatisation because of schizophrenia in spain: results

ISO2.01 Fighting stigmatisation because of schizophrenia in spain: results