title: Impact of negative symptoms on healthcare resource utilization and associated costs in adult outpatients with schizophrenia: a population-based study.
abstract: BACKGROUND
  To evaluate the prevalence and impact of negative symptoms on healthcare resources utilization and costs in patients with schizophrenia.
  
  
  METHODS
  A retrospective study was conducted using electronic medical records from the health provider BSA (Badalona, Spain). All adult outpatients with a diagnosis of schizophrenia were followed for 12 months. Two study groups were defined by the presence or absence of negative symptoms based on the PANSS Negative Symptoms Factor (N1-N4, N6, G7 and G16). Healthcare (direct cost) and non-healthcare costs (work productivity losses) were described. An ANCOVA model was used for correction, p < 0.05.
  
  
  RESULTS
  One thousand one hundred and twenty patients were included in the study (mean age: 46.8 ± 13.8 years; male: 58.4%). One or more negative symptoms were present in 52.5% of patients (95% CI: 49.6-55.4%). The most frequent were passive/apathetic social withdrawal and emotional withdrawal (60.5% and 49.8%, respectively). Patients with negative symptoms showed a greater mean number of comorbid conditions and pharmacological treatments. The adjusted unit healthcare cost related to the presence/absence of negative symptoms was €2,190.80 and €1,787.60 and the healthcare cost was €2,085.00 and €1,659.10, respectively; (p < 0.001). Patients with negative symptoms used more healthcare resources, mainly derived from primary care. The presence of negative symptoms was associated with being male, dyslipidemia, obesity and arterial hypertension (OR = 1.7, 1.4, 1.4 and 1.2, respectively).
  
  
  CONCLUSIONS
  Negative symptoms are highly prevalent in adult outpatients with schizophrenia with a relevant economic impact on the healthcare system.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sicras-Mainar
authors.forename: Jorge
authors.initials: J
authors.lastname: Maurino
authors.forename: Elena
authors.initials: E
authors.lastname: Ruiz-Beato
authors.forename: Ruth
authors.initials: R
authors.lastname: Navarro-Artieda
mesh_terms: D000328:Adult; D057565:Apathy; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D012559:Schizophrenia / Q000191:economics / Q000628:therapy*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
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