Outcome in schizophrenia: beyond symptom reduction.

Although some patients with schizophrenia may have a single episode and recover, the vast majority remain ill and unable to work for life. In the United States, patients with schizophrenia use 2.5% of the annual total health care allocations. The atypical antipsychotics, particularly when combined with psychosocial treatment, hold the promise of improving outcome and reducing the economic burden on society. Both clinical outcome and cost effectiveness are best evaluated in the context of a comprehensive assessment of a range of meaningful outcome measures studied in clinical situations. Evidence exists that the atypical antipsychotics not only reduce positive and negative symptoms and cause fewer side effects than conventional neuroleptics, but also lessen cognitive impairment, lead to a better quality of life, and have antidepressant effects, all of which should result in improved outcome in patients with schizophrenia. Increasing the availability of the atypical agents should be cost effective for society by restoring productivity in some patients with schizophrenia.