Institutionalization of patients with schizophrenia in the modern era

Introduction Patients with schizophrenia requiring long-term institutionalization represent cases with poor outcome, often leading to high costs for patients and family and constituting a huge economical burden for society if patients are young. Aims The aims were the evaluation of patient hospitalized for long period in a psychiatric hospital for chronic patients. Objectives The objectives of the study were identification of characteristics and predictors of institutionalization in schizophrenia. Methods Retrospective study of all institutionalized patients with schizophrenia in Brasov County, Romania, with a DSM-IV-TR lifetime diagnosis of schizophrenia institutionalized between 1995 and 2014. Results Institutionalized patients between 2005 and 2014 ( n = 172) had lower age (51.15 vs. 57.08, P < 0.05) and lower age at institutionalization compared with patients admitted between 1995 and 2004. Lower education level (8.23 vs. 13.22, P < 0.05), only one parent, multiple antipsychotics treatments and suboptimal response under first generation long acting antipsychotics are predictors for institutionalization. Haloperidol is the main treatment option (42.54%) followed by olanzapine 17.1% and clozapine 10.24%. Conclusions Our study showed a tendency to institutionalize patients with schizophrenia at the younger age compared with past decades. Early intervention in psychosis, controlled treatment with SGAs should be solutions to avoid institutionalization of young patients with schizophrenia. Disclosure of interest The authors have not supplied their declaration of competing interest.