Outcomes of public concern in schizophrenia.
BACKGROUND
Schizophrenia is known to be associated with a range of adverse outcomes, which have an impact atthe societal level and are therefore of public concern.


OBJECTIVE
To examine the epidemiology and methods for measuring six adverse outcomes in schizophrenia: violence, victimisation, suicide/self-harm, substance use, homelessness and unemployment.


METHODS
A review ofthe literature was carried out for each adverse outcome, with attention to critical appraisal of existing measurement tools.


RESULTS
Schizophrenia is associated strongly with all six outcomes, although research has mainly focused on violence. Each outcome acts as a risk factor for at least some of the other outcomes. There are few standardised or validated measures for these 'hard' outcomes. Each measure has inherent biases but a growing trend is for these to be minimised by using multiple measures.


CONCLUSIONS
A single instrument which systematically measures multiple societal outcomes of schizophrenia would be extremely useful for both clinical and research purposes.
Kooyman
Iain
I
Department of Forensic Mental Health, Institute of Psychiatry, London, UK. Iain.Kooyman@iop.kcl.ac.uk
Dean
Kimberlie
K
Harvey
Samuel
S
Walsh
Elizabeth
E
D015982:Bias; D019548:Crime Victims / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D012559:Schizophrenia / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*