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Outcomes of public concern in schizophrenia

Department of Forensic Mental Health Science, Institute of Psychiatry, London, UK

Samuel Harvey, MRCPsych and Elizabeth Walsh, MD

Department of Psychological Medicine, Institute of Psychiatry, London, UK

Correspondence: Dr Iain Kooyman, Department of Forensic Mental Health Science, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: Iain.Kooyman{at}iop.kcl.ac.uk

Declaration of interest None.

Background Schizophrenia is known to be associated with a range of adverse outcomes, which have an impact at the societal level and are therefore of public concern.

Aims To examine the epidemiology and methods for measuring six adverse outcomes in schizophrenia: violence, victimisation, suicide/self-harm, substance use, homelessness and unemployment.

Method A review of the literature was carried out for each adverse outcome, with attention to critical appraisal of existing measurement tools.

Results Schizophrenia is associated strongly with all six outcomes, although research has mainly focused on violence. Each outcome acts as a risk factor for at least some of the other outcomes. There are few standardised or validated measures for these`hard'outcomes. Each measure has inherent biases but a growing trend is for these to be minimised by using multiple measures.

Conclusions A single instrument which systematically measures multiple societal outcomes of schizophrenia would be extremely useful for both clinical and research purposes.

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