BACKGROUND Information on welfare cost of patients with schizophrenia and spouses is limited. AIM The main aim of this study to investigate factual societal mean annual costs per individual during 5 years before and after the initial diagnosis of schizophrenia. METHOD A register-based cohort study of 12 227 patients with incident schizophrenia (International Classification of Diseases, Tenth Revision F20-F20.99) with spouses and 48 907 matched controls in Denmark during 2002-2016. RESULTS The total annual costs of health care and lost productivity were Euro 43 561 higher for patients with schizophrenia and health care costs and costs of lost productivity were increased during 5 years before the initial diagnosis. The total annual direct health care and indirect costs of lost productivity were Euro 21 888 higher for spouses to patients with schizophrenia than spouses of individuals with no diagnosis of schizophrenia. Also before initial diagnosis, health care costs and lost productivity were increased among spouses of patients with schizophrenia. CONCLUSION Patients with schizophrenia differed from the general population with respect to all included costs. The study documented a significant burden on spouses. The excess health care costs of schizophrenia are further increased by psychiatric and somatic comorbidity, and the societal costs are 4-10 times higher than chronic neurological disorders such as epilepsy and multiple sclerosis. Early onset of schizophrenia implies that patients are affected before finishing school and before entrance to labor market. Cost savings could be achieved by investments in preventive interventions reaching young people's needs; in initiatives to reduce hospital admissions caused by medication side effects, substance misuse, and lifestyle factors; and in occupational training.

中文翻译：

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丹麦精神分裂症的社会成本：初诊前后患者和配偶的全国性配对对照研究。

背景技术关于精神分裂症和配偶患者的福利成本的信息是有限的。目的本研究的主要目的是调查精神分裂症初次诊断前后5年内每个人的事实社会平均年度花费。方法在2002年至2016年期间，基于配偶的队列研究对12 227例精神分裂症患者（国际疾病分类，第十次修订F20-F20.99）及其配偶和48 907名相匹配的对照组进行了研究。结果精神分裂症患者的年度医疗保健和生产力损失的总费用增加了43561欧元，并且在初次诊断之前的5年内，医疗费用和生产力损失的费用有所增加。精神分裂症患者的配偶每年的总直接卫生保健和生产力损失的间接成本比没有诊断为精神分裂症的个人的配偶高21 888欧元。同样在初诊之前，精神分裂症患者配偶的医疗保健费用和生产力损失也增加了。结论精神分裂症患者的所有费用均与普通人群不同。该研究记录了配偶的沉重负担。精神病和躯体合并症会进一步增加精神分裂症的医疗保健费用，其社会费用比诸如癫痫病和多发性硬化症等慢性神经系统疾病高4-10倍。精神分裂症的早期发作意味着患者在完成学业之前和进入劳动力市场之前会受到影响。可以通过投资预防性干预措施来满足年轻人的需求，从而节省成本；采取措施减少因药物副作用，药物滥用和生活方式因素引起的住院人数；和职业培训。