SCHIZOPHRENIA MODELING- FACTORS ASSOCIATED WITH THE RISK OF BEING IN A SPECIFIC DISEASE STATE
Author(s)
Dragomir A1, Angers JF1, Tarride JE2, Rouleau G1, Drapeau P1, Perreault S11University of Montreal, Montréal, QC, Canada, 2McMaster University, Hamilton, ON, Canada
As a first step to model schizophrenia, we are proposing a research project aimed at better understanding the factors associated with specific disease states associated with schizophrenia. OBJECTIVES: To evaluate the factors associated with the risk of being in a specific disease state of schizophrenia. METHODS: The model was based on data from RAMQ and Med-Echo databases. A total of 12,754 newly diagnosed patients with schizophrenia patients were identified. Six discrete disease states were defined within the model (first episode – FE, low dependency state – LDS, high dependency state – HDS, Stable, Well and Death) and patients’ movements between these disease states enabled 17 risks to be identified. To evaluate factors associated to the risk of being in each disease state, we constructed five risk functions based on Cox proportional hazard analysis for competing risks. The risk factors included in the models were age, gender, social assistance status, severity of schizophrenia, depression, anxiolytic drugs use and other mental disorders. RESULTS: After the FE of schizophrenia, 69.8% of patients transitioned to LDS, 11.2% to HDS, 1% to the death state and 18% into the Well state. Being male (HR: 0.93, 95% CI: 0.89-0.97) or older (HR: 0.94, 95% CI: 0.91-0.96) was associated with a decreasing risk of moving to LDS after being FE. In contrast, being on social assistance, depressed, using anxiolytic drugs or being diagnosed with other mental disorders were associated with an increased risk of being in a LDS after a FE, ranging from 1.11 to 1.55 folds. CONCLUSIONS: Some of our results are consistent with those obtained from the published literature. Based on these risk functions we estimate individual transition probabilities that will be used in the first Canadian model of schizophrenia incorporating transition probabilities adjusted for individual risk factors profiles using Canadian data.
Conference/Value in Health Info
2009-10, ISPOR Europe 2009, Paris, France
Value in Health, Vol. 12, No. 7 (October 2009)
Code
PMH18
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
Mental Health