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精神分裂症样障碍的成本:一项匹配对照的全国性基于登记的患者和配偶研究。

Costs of schizotypal disorder: A matched-controlled nationwide register-based study of patients and spouses.

机构信息

Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.

Faculty of Health Sciences, Danish Center for Sleep Medicine, Neurophysiology Clinic, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

出版信息

Acta Psychiatr Scand. 2021 Jul;144(1):60-71. doi: 10.1111/acps.13292. Epub 2021 Mar 17.

Abstract

OBJECTIVE

Information on societal cost of patients with schizotypal disorder is limited. The aim was to investigate the societal costs of schizotypal disorder before and after initial diagnosis including both patients and their spouses.

METHODS

A register-based cohort study of 762 patients with incident schizotypal disorder (ICD-10; F21) including their spouses and 3048 matched controls, during 2002 to 2016. Total healthcare costs, home care costs, and costs of lost productivity of patients and spouses were included in the analysis.

RESULTS

Total costs amounted €47,215 per year for patients with schizotypal disorder, which was fifteen times higher than the matched controls. Of these, 41% were healthcare and home care costs and 59% were costs of lost productivity. Healthcare costs and costs of lost productivity were increased during five years before initial diagnosis of schizotypal disorder. Total costs of spouses to patients were €21,384 compared with € 2519 among spouses of controls. 75% of the total costs of spouses to patients were related to lost productivity. The total costs were higher than the costs of borderline personality disorder, but on the same level as the costs of schizophrenia identified in earlier comparable studies.

CONCLUSIONS

The total societal costs of patients with schizotypal disorder drawn from national registers differed substantially from the controls representing the general population. As evidence-based recommendations for diagnoses and treatment of patients with schizotypal disorder do not exist, future research should focus on developing effective treatment for this group of patients to reduce cost of illness.

摘要

目的

关于精神分裂型人格障碍患者的社会成本信息有限。本研究旨在调查精神分裂型人格障碍患者在初次诊断前后的社会成本,包括患者及其配偶。

方法

这是一项基于登记的队列研究,共纳入了 762 例初次诊断为精神分裂型人格障碍(ICD-10:F21)的患者及其配偶,以及 3048 名匹配对照者。分析中包括患者和配偶的总医疗保健费用、家庭护理费用以及患者和配偶的生产力损失成本。

结果

精神分裂型人格障碍患者每年的总费用为 47215 欧元,是匹配对照组的 15 倍。其中,41%为医疗保健和家庭护理费用,59%为生产力损失成本。在初次诊断精神分裂型人格障碍之前的五年内,医疗保健费用和生产力损失成本增加。与对照组配偶的 2519 欧元相比,患者配偶的总成本为 21384 欧元。患者配偶总成本的 75%与生产力损失有关。总的来说,患者的总成本高于边缘型人格障碍的成本,但与之前类似研究中确定的精神分裂症的成本水平相当。

结论

从国家登记处获取的精神分裂型人格障碍患者的总社会成本与代表一般人群的对照组有很大差异。由于目前缺乏针对精神分裂型人格障碍患者的诊断和治疗的循证建议,未来的研究应重点开发针对该患者群体的有效治疗方法,以降低疾病成本。

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