This week includes stark data on schizophrenia patients, an unexpected clozapine risk, and the benefits of a new approach to treatment-resistant depression.
New Data Uncovers Higher Costs, Poorer Health, and Steeper Social Burdens
An analysis of U.S. Medical Expenditure Panel Survey data (1997–2021) has found that more than half of adults living with schizophrenia experience cognitive impairments – defined as memory, concentration, or decision-making problems. These challenges make life dramatically more difficult, adding to clinical, economic, and personal burdens.
The new paper – appearing in The Journal of Clinical Psychiatry – reports that among an estimated 661,243 adults with schizophrenia, 57.7% reported cognitive limitations and 53.8% reported cognitive difficulties. Those living with the burden of cognitive limitations endured:
- Higher rates of anxiety, depression, and obesity.
- Lower education and income.
- And greater poverty.
The data reveal a much higher utilization of health care services, including prescriptions and outpatient visits. These patients incur annual health care costs averaging more than $18,000. That’s roughly 1.6 times higher than those living without such impairments.
Humanistic impacts were just as startling. Individuals with cognitive limitations were more likely to report poor health, limitations in daily and instrumental activities, and posted lower quality-of-life scores. These people also struggled to stay employed, with a 15.3% higher unemployment rate driven by illness or disability, Naturally, that resulted in a drop in annual wages.
Regression analysis confirmed a link between cognitive limitations and 47% higher odds of hospitalization, 64% higher odds of emergency department visits, and much higher total health care costs. These associations persisted even after researchers adjusted for demographics.
Cognitive difficulties showed similar cost patterns but failed to expose a link to higher hospitalization or ED visit rates.
The researchers concluded that cognitive impairments in schizophrenia impose overwhelming, multifaceted burdens. As a result, they call for targeted interventions (both clinical and psychosocial) to boost patient outcomes, cut costs, and address the social determinants of health driving these disparities.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- The Primary Care Companion for CNS Disorders reports that clozapine can cause gastrointestinal hypomotility that can progress to life-threatening obstruction.
- JCP also documents a clinical trial that found that in treatment-resistant depression, augmenting existing antidepressants with aripiprazole and repetitive transcranial magnetic stimulation (rTMS) can help.
- PCC has published a case report about an elderly woman with dementia who developed sudden confusion and somnolence from divalproex-induced hyperammonemia.
- And our news department reports on Illinois’ recent ban on AI in clinical settings.
- Finally, catch up on the latest in our “Emerging Approaches in Schizophrenia” ongoing series.
