HAPS Study

Hospitalization Among Patients with Schizophrenia Spectrum Disorders (SSD)


Obiora Onwuameze, MD (Faculty, Adult Division)

Vinod Alluri, MD (Faculty, Adult Division)

Objective: The objectives of this project are to 1) Determine the relationship between depression and hospitalization in patients with SSDs; 2) evaluate psychotic symptoms as a predictor of hospitalization in SSDs patients; 3) assess diagnosis of schizophrenia versus schizoaffective disorder as a predictor of hospitalization in SSD patients; and 4) develop a preliminary predictive model of variables for hospitalization in SSDs.

Background: The most recent statistics show that the direct cost of SSDs in the United States was $22.7 billion in 2002, with a total overall cost of $62.7 billion. It is estimated that anywhere from 15% to 58% of total direct cost is due to repeated hospitalization. This means that schizophrenia is perhaps one of the most costly chronic illnesses. Previous studies have reported psychotic symptoms, depression, and dangerous behavior, including homicidal and suicidal ideations, as predictors of hospitalization. Other factors include early age of onset, alcohol use, and non-adherence. We recently conducted a retrospective study using data from a small cohort of patients followed in an assertive community treatment program and found that depression predicted hospitalization but not psychotic symptoms.

Design: A longitudinal prospective design with repeated assessments, involving a sample of approximately 60 subjects, with assessments at baseline, 3, 6, and 9 months.