People with schizophrenia spectrum disorders (SSD) have high rates of comorbid mental and/or substance use disorders and poor social and economic functioning, yet only a quarter received minimally adequate treatment in the previous year, according to a report in Psychiatric Services.
“These findings further suggest that existing treatment and social welfare approaches are not meeting the needs of many people with schizophrenia spectrum disorders,” wrote Natalie Bareis, L.M.S.W., Ph.D., of the department of psychiatry at Columbia University Irving Medical Center, and colleagues.
The report made use of data from the Mental and Substance Use Disorders Prevalence Study (MDPS), a nationally representative survey funded by the Substance Abuse and Mental Health Services Administration and designed to obtain unbiased and inclusive estimates of the prevalence of mental and substance use disorders among U.S. adults ages 18 to 65 living in households.
The MDPS used trained clinicians to administer the Structured Clinical Interview for DSM-5 to 4,764 individuals. A total of 114 individuals were identified with SSD. Among those, more than half (52%) had a major depressive episode in the previous year, while 35% had one or more comorbid psychiatric disorders. More than one-third had a substance use disorder; the most common were alcohol use (23%) and cannabis use (20%) disorders.
Compared with those without SSD, those with SSD were less likely to have completed college (4% vs. 32%) and less likely to be employed (17% vs. 61%). Those with SSD were also less likely to be married or in a romantic relationship.
Overall, 71% of individuals with lifetime schizophrenia spectrum disorders reported some mental health treatment in the past year—56% had at least one outpatient visit, 9% had an inpatient or residential stay, and 58% were currently taking a psychotropic medication. However, just 26% received minimally adequate treatment—defined as taking one or more antipsychotic medications and having four or more outpatient mental health visits in the past year—despite the fact that most of the individuals had health insurance.
The authors noted that there are several effective, evidenced-based interventions for SSD, including assertive community treatment and coordinated specialty care. “Policies to improve access to and use of existing evidence-based interventions are essential,” they wrote. “Innovative interventions and implementation strategies, along with research to examine their effectiveness, will be critical to improve outcomes for people with schizophrenia spectrum disorders.”
For related information, see the Psychiatric News article “Study Calculates Disability Caused by Schizophrenia.”
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