Health care expenditure on schizophrenia patients in Belgium.

Schizophrenia generates a great deal of cost and burden. The aim of this study was to assess the direct costs for schizophrenia patients receiving standard treatment in different settings in Belgium. Costs were calculated for patients and for the Belgian insurance system. Data from Belgium's largest sickness fund were used to estimate health expenditures for all schizophrenia patients in Belgium. The mean direct treatment cost was $12,050 per patient per year, or $304 million for all schizophrenia patients per year. This cost constitutes 1.9 percent of the Belgian Government's total health expenditure. Government expenditure per schizophrenia patient is 10 times that of an average citizen.

Depressive symptoms and employment status among Belgian adolescents.

The association of employment status and depressive symptoms was assessed by means of the Center for Epidemiological Studies-Depression (CES-D) scale in a population of 898 male and female subjects aged 16 to 21. The unemployed subjects (N = 300) scored significantly higher on depressive symptoms than did the students (N = 300) or the employed workers (N = 298) even when gender was controlled. Although the quantity of depressive symptoms differed, the nature of the symptoms experienced was similar in the three groups. Affective symptoms were more common than symptoms in somatic or interpersonal areas, suggesting that in adolescence and young adulthood there is a high degree of affective disturbance. We conclude that primary unemployment is associated with a substantial degree of depressive morbidity.

[Sociodemographic profile and types of psychiatric patient care management in the Brussels area]. / Profils socio-démographiques et type de prise en charge des patients psychiatriques dans la Région Bruxelloise.

The analysis of the socio-demographic and psychiatric characteristics of a representative sample of patients in Brussels (n = 1216) shows a relation between the type of patient and the type of institution. We observed two separate social and psychiatric profiles. There is a "recent" population in the Mental Health Centers and in the new psychiatric services in general hospitals. This population is mainly female, married, socially integrated and suffer essentially from affective disorders. These patients have had recent contacts with psychiatric services and have rarely been hospitalized. The second population is "seriously chronic" and is hospitalized in psychiatric hospitals and in day or night hospitals. The patients are mainly male, single, isolated and depend on welfare. They have more psychotic disorders and have consulted psychiatric services for many years with numerous hospitalizations. This distinction shows the existence of two psychiatry networks in Brussel.

[Depressive symptoms in adolescents (1). Prevalence - remedy]. / Symptomes dépressifs chez l'adolescent (1). Prévalence - recours.

This study concerns a population of 900 Belgian adolescents aged 16 to 21, i.e. 300 students, 300 workers and 300 unemployed. They accepted to answer a detailed questionnaire including a French version of the CES-D scale (Center for Epidemiological Studies-Depression). The prevalence rates of depressive symptoms observed in Belgium are higher than those found in the US. Moreover the Belgian adolescents observed in this study reach more often than U.S. adolescents the level of "clinical depressions" (18.9%). The rates are still higher when "occasional depressive symptoms" are also considered (occurrence: 1-2 days during the last week). However comparisons of this kind cannot be interpreted in a simplistic way. The rates vary with the social status of the adolescents: the unemployed present the highest level, followed by students; the workers have, comparatively, the lowest rates. These high prevalence rates require in depth analyses. The adolescents may need medical, psychological or social assistance which should be offered, at the primary care level. However their own choice leads them to get help elsewhere: close friends, partners (couple), simple friends (in French: "copain" and "copine"), siblings etc. Adolescents consult their doctor only exceptionally. This raises important questions, namely in the field of the training of health personnel.