Direct and indirect costs of schizophrenia

In the present study the costs of schizophrenia in Germany were studied usi ng the "bottom up" prevalence-based method. In a random sample of 180 schiz ophrenic patients stratified according to the most important care instituti ons, direct and indirect costs were retrospectively documented for a 12-mon th period. Depending on the place of recruitment and the extent of care pro vided, total yearly costs result between about DM 33,000 for a patient trea ted predominantly on an outpatient basis and about DM 126,000 for a patient requiring hospital care and about DM 135,000 for a patient in job rehabili tation. The direct yearly treatment costs were, as expected, lowest for pat ients recruited in the private practice of a psychiatrist and predominantly treated on an outpatient basis (DM 5,788), and were the highest in the psy chiatric hospital (DM 64,661) and in job rehabilition (DM 79,996). In the p atients recruited in the outpatient domain, doctors' fees and medication to gether were responsible for only 4.5% of the total costs, whereas the indir ect costs (e.g. through work incapacity) were responsible for 87% of the to tal yearly costs. For methodological reasons the total costs caused by schi zophrenic psychoses in Germany per year can at present be estimated only ro ughly. A conservative estimate is between 8.5 and 18 billion DM per year. T he study shows that schizophrenia is a very expensive illness, the direct a nd indirect costs of which are on the whole comparable to those of the comm on somatic illnesses. Therefore, also for economical reasons, sufficient fi nancial means should be invested in the research and treatment of this seve re illness.