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Country differences in patient characteristics and treatment in schizophrenia: data from a physician-based survey in Europe

Published online by Cambridge University Press:  16 April 2020

G. Papageorgiou ,
F. Cañas ,
M. Zink  and
A. Rossi
G. Papageorgiou*
Affiliation:
Department of Psychiatry, Evangelismos General Hospital, 45 Ypsilandou str. GR-106 76, Athens, Greece
F. Cañas
Affiliation:
Hospital Dr. Rodríguez Lafora, Department of Psychiatry, Cra. De Colmenar Viejo km 13,8, Madrid, Spain
M. Zink
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Mannheim, Germany
A. Rossi
Affiliation:
Section of Neurosciences, Department of Experimental Medicine, University of L’Aquila, L’Aquila, Italy
*
*Corresponding author. Tel.: +30 (210) 810 4410. E-mail address:freud54@otenet.gr
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Abstract

Schizophrenia is a frequent psychiatric disorder whose prevalence appears to be relatively stable across different patient groups. However, attitudes to care and resources devoted to mental health care may differ between countries. The objective of this analysis was to compare sociodemographic and psychopathological features of patients, antipsychotic treatment and frequency of hospitalisation between four European countries (Germany, Greece, Italy and Spain) collected as part of a large survey of the characteristics of patients with schizophrenia. The survey was conducted by structured interview of 744 randomly-selected psychiatrists in four European countries who recruited 3996 patients. Information on 39 variables was collected. A number of between-country differences were observed which tended to distinguish Germany on the one hand, from the Mediterranean countries, and Greece in particular, on the other. While demographic features and clinical features were essentially similar, more patients in Germany were considered to have severe disease by their psychiatrist (59.0% versus 35.9% in Greece) and to be hospitalised (49.3% versus 15.0%). 46.7% of German patients were living alone compared to less than 20% in the Mediterranean countries and 50.2% were living with their family (versus over70% elsewhere). Smoking and addictive behaviours were more frequently reported for patients in Spain. With regard to empirically derived patient subgroups, Subgroup 2, corresponding to well-integrated and autonomous patients with mild to moderate disease severity was most highly represented in Greece (23.6% of patients compared to less than 10% elsewhere) elsewhere, Subgroup 6 (poorly-integrated patients with moderately severe disease who require caregiver support) was under-represented in Germany (4.5% versus over 17% elsewhere). Patterns of treatment were essentially similar, although quetiapine was more frequently prescribed and paliperidone less frequently prescribed in Germany than elsewhere. Reasons for treatment choice were comparable between countries, primarily related to good tolerability and control of positive symptoms. The differences observed may be attributed to differences in mental health care resource provision, socio-cultural or educational differences or to resource issues.

Keywords

SchizophreniaCountry differencesAntipsychoticsPatient subgroupsPatient characteristicsHealth provisionComorbidities
Type
Research Article
Information
European Psychiatry , Volume 26 , Issue S1: Patients with schizophrenia: Results of a physician-based survey conducted in four European countries (Germany, Greece, Italy and Spain) , March 2011 , pp. 17 - 28
Copyright
Copyright © European Psychiatric Association 2011

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