More UK Psychiatrists See Devastating Consequences Of Relapse Among Severe Mentally Ill Than European Counterparts

Main Category: Psychology / Psychiatry
Also Included In: Mental Health;  Depression;  Schizophrenia
Article Date: 03 Sep 2008 - 3:00 PDT

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More UK psychiatrists witness the dramatic consequences of relapse among the seriously mentally ill than their European colleagues, says a new international survey of psychiatrists released today (3nd September, 2008). This is despite major treatment advances.

According to the findings of the survey (commissioned jointly by the WFMH and Eli Lilly and Company Ltd.), over half of practising UK psychiatrists (54 per cent) have patients go to prison1, and more than eight out of ten (86 per cent) have patients talk of suicide after relapsing from their condition - the highest proportions in Europe.1 Together with those in France (85 per cent), psychiatrists in the UK report the highest rate of relapse associated violence (87 per cent)1 in Europe. More UK clinicians than in any other European country cite social isolation and damage to relationships (87 per cent)1 following the return of their patients' psychotic symptoms.

"The emotional, physical and social cost of relapse can be devastating - not only to the person living with severe mental illness, but also to everyone around them," comments Preston Garrison, Secretary-General and Chief Executive Officer, World Federation for Mental Health, on presenting the data from Part II of the Keeping Care Complete survey. "Some patients suffer multiple relapses over the course of their lives making the risks of traumatic life events even greater."

The survey provides perspectives of nearly 700 psychiatrists among nine western nations into the impact of relapse on the lives of people living with schizophrenia, schizoaffective disorder and bipolar disorder.

Causes of relapse

Despite the availability of effective treatments, nearly all UK psychiatrists (99 per cent) agree that lack of adherence to medication can be a significant cause of relapse in patients with schizophrenia.2 In addition, UK psychiatrists report that hospitalization (94 per cent), manic behaviour (87 per cent), and hostility (85 per cent) have occurred as a direct result of patients stopping taking their medication.2

According to the research, reasons that patients don't adhere or stop taking medication include their perceived lack of need for the medication, unmanageable side effects, or simply because they forget to take it.2

Nearly all (96 per cent) of UK psychiatrists have also seen a stabilised patient relapse following a medication change.2

Treatment successes

"When patients are successfully managed on treatments, they are less likely to relapse and exhibit the negative behaviours often associated with the worsening of their condition" says Dr Richard Hodgson, Consultant Psychiatrist at North Staffordshire Combined Healthcare NHS Trust.

Most UK psychiatrists (96 per cent) have had patients stay out of the hospital as a result of successful treatment. Large percentages of UK psychiatrists reported other positive outcomes associated with successful treatment, 92 per cent cited patients becoming more independent, 90 per cent cited patients exhibiting less hostility, and 89 per cent cited patients re-engaging with family and friends.2

"Once a relapse has occurred it makes it much more difficult for people to settle happily back into family life, to integrate with their communities and to re-establish their jobs, return to hobbies or resume a social life. Therefore, finding an effective treatment to take control of their symptoms and provide them with quality of life is essential and the primary goal of managing this group of patients" adds Dr Hodgson.

Stigma

According to the research, nine out of ten UK psychiatrists have a patient struggling to stay on medication due to negative depictions of mental illness in the media.2

"We need to show more understanding and acceptance" says Marjorie Wallace, Chief Executive of mental health charity SANE. "We should offer both psychological support and more straightforward strategies on taking medication, giving more information on the balance of benefits and side effects of different medications. If people do not understand how to prevent their condition worsening, the cost to the individual, society and our healthcare system will continue to be heavy".

One in a hundred people is diagnosed with schizophrenia in the UK3 and one to two percent of the general population is diagnosed with bipolar disorder.4

The estimated total societal cost of schizophrenia in England is approximately £7.3 billion per year.5,6 On average, a relapse in schizophrenia costs the NHS £11,923 over six months.6,7 The average cost of bipolar disorder per manic episode is £6,780.6,8

About The Keeping Care Complete Survey

The survey, commissioned jointly by the WFMH and Eli Lilly and Company Ltd., provides perspectives of nearly 700 psychiatrists among nine western nations into the impact of relapse on the lives of people living with schizophrenia, schizoaffective disorder and bipolar disorder.

About WFMH

The World Federation for Mental Health (WFMH) is an international interdisciplinary membership organization committed to promoting, among all people and nations, the highest possible level of mental health in its broadest biological, medical, educational, and social aspect. Consultative status at the United Nations provides WFMH a variety of opportunities to engage in mental health advocacy at the global level, working closely with the World Health Organization, UNESCO, the UN High Commissioner for Refugees, the UN Commission on Human Rights, the International Labor Organization and others. Additional information about WFMH is available at http://www.wfmh.org.

About Eli Lilly and Company

Eli Lilly, a leading innovation-driven corporation, is developing a growing portfolio of first-in-class and best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., USA. Lilly provides answers - through medicines and information - for some of the world's most urgent medical needs. Additional information about Lilly is available at http://www.lilly.com.

References

1. Keeping Care Complete II. International Psychiatrists Survey. September 2008. IPSOS Marketing. Global results report.

2. Keeping Care Complete II. International Psychiatrists Survey. September 2008. IPSOS Marketing. UK results report.

3. Understanding Schizophrenia, MIND information, accessed here.

4. Understanding bipolar disorder, MIND information, accessed here.

5. Mangalore R and Knapp M, Cost of schizophrenia in England. The Journal of Mental Health Policy and Economics 2007: 109: 23-41

6. Unit costs of health and social care, 2007, Lesley Curtis, PSSRU, accessed at http://www.pssru.ac.uk (inflation rates applied to references 5, 7 & 8)

7. Almond S, Knapp M, Francois C et al. Relapse in schizophrenia: costs, clinical outcomes and quality of life. British Journal of Psychiatry 2004: 184: 346-351

8. McKendrick J et al. Cost effectiveness of olanzapine in prevention of affective episodes in bipolar disorder in the United Kingdom. J Psychopharmacol 2007;21:588-596

Eli Lilly and Company