Differences between groups were superimposed on a model MRI image.
Orange circles indicate areas of decreased gray matter density in the frontal and temporal lobes of patients with schizophrenia.
In Adult Patients With Schizophrenia
Recurring Relapses Are a Cause For Concern
The first 3-5 years after a schizophrenia diagnosis are a critical period for patients. Disease progression during this period is often quite rapid, which can lead to worse patient outcomes.1
A comprehensive schizophrenia treatment plan will likely center on relapse prevention as a goal and measurement of success.2,3
The Effects of Schizophrenia Pervade the Lives of Adult Patients4-6
20% homeless rate
in a study of patients with schizophrenia and other serious mental illnesses within a large public mental health system4
Suicides, drug overdoses, and accidents
account for most deaths in the younger schizophrenia population5
90% unemployment rate
in a population-based study of patients with schizophrenia and schizoaffective disorder6
Consistent Treatment Matters
The Risks of Nonadherence
Within 6 months posthospitalization,
7 out of 10
patients are nonadherent on oral antipsychotics7
Adherence and Mortality Outcomes
According to a retrospective claims analysis of a multistate Medicaid database, adult patients taking LAls vs OAPs had:
65%lower riskof nonadherence7*†‡
In a Scandinavian longitudinal cohort analysis, use of an LAI vs an equivalent dose of an OAP was associated with:
33%lower riskof death8§
*Based on all LAIs and OAPs approved for use in the United States as of July 2013.
†Based on proportion of days covered <0.8.
‡Results presented here reflect a single claims analysis. other studies have not found a significant difference between LAIs and OAPs. Limitations: Some differences exist across groups despite attempts to minimize these; access issues may be a confounding variable, and adherence measures may overestimate OAP adherence. Other limitations included limited availability of data, lack of clinical severity measures or patient-reported self-measures, and data on duration of illness or prior treatment response.
§Based on all LAIs and OAPs approved for use in Sweden as of December 2013.
Timing of Intervention Matters
This chart demonstrates that periods of untreated illness (including relapses) can negatively impact functional ability over time.
- Periods of untreated illness (including relapses) can lead to worse long-term outcomes9
- To improve outcomes, an early, effective, and comprehensive treatment plan is imperative to minimize loss of functional ability—especially during the first 3-5 years after a diagnosis of schizophrenia, when disease progression is rapid9
Actor portrayal.
Loss of Functional Ability Over Time10*
Brain Health Matters
Schizophrenia can be associated with a loss of brain volume and cortical gray matter.9,11-14 During the early years after a diagnosis of schizophrenia, longer duration of relapses can lead to more pronounced changes.11
Areas of Gray Matter Loss
Loss of Brain Volume Over 5 Years13†
Progressive changes in brain volume and structure can be linked to other factors, including medical comorbidities common in patients with schizophrenia, alcohol and drug use, environmental exposures, disease heterogeneity, and the effects of antipsychotic medications.11,15-21
More recent data are emerging that continue to explore the relationships between schizophrenia and cortical matter changes.14
Recurring Relapses:
A Cause for Concern
Recurring relapses in adult patients with schizophrenia are likely a cause of concern for members of their treatment team. In fact, a longitudinal database study of adults with stable schizophrenia found that risk of all-cause mortality increased with each schizophrenia relapse.22
Actor portrayal.
Relapse Frequency Matters
In the longitudinal study, each of the first 5 relapses increased all-cause mortality by approximately 20%22
LAI=long-acting injectable; OAP=oral antipsychotic.
*Adapted from Lieberman, et al. Am J Psychiatry. 2019
†Adapted from van Haren, et al. Neuropsychopharmacology. 2007.
Related Videos
Body of Evidence
Highlights increased mortality, medical, economic, and social burdens faced by schizophrenia patients, underscoring the critical need for improved care strategies to enhance patient outcomes.
Body of Evidence
Advises clinicians to discuss LAIs earlier after diagnosis, recommending motivational interviewing techniques, shared decision-making, and positive framing of the treatment benefits.
References
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