ObjectiveDisease prevalence, comorbid conditions, and pharmacological treatments were examined in a large population of US commercial- or Medicaid-insured individuals with schizophrenia.MethodsThis retrospective, cross-sectional claims analysis sourced data from the IBM MarketScan Commercial and Medicare Supplemental Databases and the Multi-state Medicaid Database (01Jan2009 to 30Jun2016). Cases were defined by =1 diagnostic claim (ICD-9-CM/ICD-10-CM) for schizophrenia during the study period. Comorbidities (=1 ICD-9-CM/ICD-10-CM diagnosis code) were grouped according to Clinical Classifications Software (CCS) level 2 categories. For the per-database analysis of comorbidities, schizophrenia cases were matched with controls by demographic characteristics. Case-control comorbidity comparisons were performed using prevalence rate ratios (PRRs) and 95% CIs. Per-database medication exposure (=1 National Drug Code in outpatients grouped by Redbook classification) was also assessed.ResultsSchizophrenia prevalence was 0.11% and 0.99% in commercially and Medicaid-insured patients, respectively. In both databases, comorbidity prevalence was higher among schizophrenia cases versus controls in approximately =80% of the CCS level 2 categories assessed. Common top categories of comorbidities for schizophrenia cases were mood disorders, anxiety disorders, other connective tissue disease, and diseases of the heart. Comorbidities with the highest case-control PRRs included personality disorders, suicide and intentional self-inflicted injury, and impulse control disorders. Across databases, the most commonly prescribed medications in cases were antipsychotics, antidepressants, and analgesics/antipyretics opiate agonists; the most highly prescribed antipsychotics were risperidone, quetiapine, aripiprazole, and olanzapine.ConclusionsThis large-scale analysis quantifies the high prevalence of medical and psychiatric comorbidity burden in patients with schizophrenia, highlighting the importance of integrated medical and psychiatric care.FundingAlkermes, Inc.

中文翻译：

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美国精神分裂症患者的疾病患病率、合并症和药物使用情况

目的在大量美国商业或医疗补助保险的精神分裂症患者中检查疾病患病率、合并症和药物治疗。州医疗补助数据库（2009 年 1 月 1 日至 2016 年 6 月 30 日）。病例由研究期间精神分裂症的 = 1 个诊断声明 (ICD-9-CM/ICD-10-CM) 定义。合并症（=1 ICD-9-CM/ICD-10-CM 诊断代码）根据临床分类软件 (CCS) 2 级类别进行分组。对于合并症的每个数据库分析，精神分裂症病例与人口统计学特征的对照相匹配。使用患病率比 (PRR) 和 95% CI 进行病例对照合并症比较。还评估了每个数据库的药物暴露（= 1 个按红皮书分类分组的门诊患者国家药物代码）。结果商业和医疗补助保险患者的精神分裂症患病率分别为 0.11% 和 0.99%。在这两个数据库中，在大约 = 80% 的 CCS 2 级评估类别中，精神分裂症病例的合并症患病率高于对照组。精神分裂症病例中常见的顶级合并症是情绪障碍、焦虑症、其他结缔组织疾病和心脏疾病。病例对照 PRR 最高的合并症包括人格障碍、自杀和故意自我伤害以及冲动控制障碍。跨数据库，病例中最常用的处方药是抗精神病药、抗抑郁药和镇痛药/解热药鸦片激动剂；处方最多的抗精神病药是利培酮、喹硫平、阿立哌唑和奥氮平。结论这项大规模分析量化了精神分裂症患者内科和精神共病负担的高患病率，突出了综合医疗和精神科护理的重要性。FundingAlkermes, Inc.