[Costs of schizophrenia - what we know (not)?]

Schizophrenia is regarded as one of the most expensive mental illnesses because of its specific symptoms and characteristics. The care of schizophrenic patients consumed approx. 2 % of the total German health care expenditures in 1994, according to the scarce data provided by routine German health reporting. Despite this enormous impact, health-economical research in schizophrenia in Germany is widely neglected. While few empirical studies on direct cost of care for schizophrenic patients suggest that adequate comprehensive community care in Germany during the mid-nineties was about DM 27 000 to DM 28 000 per patient and year, there is a serious lackage of cost-effectiveness-studies, relating cost of care to outcome. Thus, the most basic data for any health care planning in schizophrenia is missing. This paper reviews the studies on cost of schizophrenia in Germany. It identifies the most serious knowledge gaps and describes the obstacles for an adequate research in this field.