摘要:

The antidelusion effect, in the antiproductive sense of the term, represents the essential property of neuroleptics in research and publications in the United States. In France and in other European countries, however. a particular effect was observed early on that received various labels: disinhibitor, stimulant, antiautistic and anti‐deficit, and that involved the beneficial action of certain neuroleptics on the negative symptoms of schizophrenia. The first period, ranging from 1952 to 1976, was characterized by a number of clinical observations and attempts at classification. In the second period, 1976 to 1984, much work was done in pharmacology and biochemistry. In the third period, 1984 to 1989, double‐blind studies confirmed, among others, the disinhibiting effect, first of low doses of sulpride and then of amisulpr

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05838.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05854.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Two approaches can be used to estimate the cost of schizophrenia. Prevalence‐based cost provides an estimate of the direct and indirect economic burden incurred in a period of time as a result of the prevalence of schizophrenia during the same base period, most often a year. Incidence‐based cost represents the lifetime cost resulting from the illness. Different examples of studies applying the 2 methods are illustrated, by stressing the advantages and the pitfalls of both. The incidence‐based approach is the most appropriate for the purpose of making decisions about which treatment to implement. Cost analysis of lifetime schizophrenia requires reliable data on service use and treatments and particular methodological instruments. In particular. since schizophrenia is in many cases a chronic disease. pharmacoeconomic evaluation should also be applied using an incidence‐based approach rather than a short period of tr

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05871.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05855.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Programmes for controlling health care costs and improving the quality of care are going to be developed in some countries, with the development of health services research and outcome evaluation. The reliable and comprehensive evaluation of the specific health and economic picture of each illness as well as of the health care results and costs savings related to the treatments or coordination of treatments requires close, interdisciplinary collaboration between the clinician and the health economist. The production and diffusion of health and economic evaluation results is aimed at informing policy makers, providers, consumers, health technology producers, etc. in order to enable them to do their best choices. The allocation in each country of a significant percentage of the annual health expenditures to economic evaluation in mental health seems important for the international development of this field.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05872.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Three sorts of economic studies have addressed the treatment of schizophrenia. Studies of the total costs of the illness to whole communities have examined the economic effects of changes in both the illness and its treatment; naturalistic studies of cohorts of patients have addressed relationships between costs, needs and clinical outcomes; and randomized controlled trials of various kinds of community care and traditional care have produced data on the relative cost effectiveness of the new treatments. The Madison model of training in community living is generally cheaper for society than traditional care, consistently produces better satisfaction and, in some studies, has produced better clinical outcomes as well. Other models of care have produced similar outcomes at lower cost. A study that includes home‐based rehabilitation for patients with established schizophrenic illnesses has produced better outcomes at similar costs. In general terms, cost savings are achieved by shortening the length of stay in hospital. Day care — often preceded by a short admission — has been shown to be cost‐effective as an alternative to traditional hospitalization. The results of randomized control trials cannot be generalized to all those needing acute admission to hospital, since all studies have excluded many patients from the trials. There is some evidence that higher community costs are associated with better o

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05873.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05874.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY