# Clinical, social, and economic burdens of schizophrenia in Japan: a targeted literature review

## TL;DR

This review explores the clinical, social, and economic impacts of schizophrenia in Japan, highlighting the need for coordinated interventions to reduce patient and caregiver burdens.

## Contribution

The study provides a comprehensive analysis of schizophrenia's multifaceted burdens in Japan, emphasizing gaps in stakeholder-driven initiatives.

## Key findings

- Cognitive impairment in schizophrenia is severe, with a Z-score of -2.1 on the Brief Assessment of Cognition in Schizophrenia.
- Caregivers face significant productivity losses, with an estimated annual loss of JPY 2.4 million due to presenteeism.
- Interventions targeting cognitive function and community cooperation are key to reducing early readmission rates.

## Abstract

Schizophrenia is a severe mental disorder with substantial clinical, economic, and humanistic impacts. This targeted literature review evaluated the burden of schizophrenia on patients and caregivers in Japan. Data were collected from PubMed, Ichushi, CiNii, J-STAGE, and the Cochrane Database (2013–2023) and supplementary materials from medical associations, government agencies, and patient organizations (2018–2023). The review focused on epidemiology, clinical management, societal, humanistic, and economic burdens experienced by patients and caregivers. The review identified 156 journal publications, 73 conference proceedings, and 37 additional data sources. Obesity, depression, and type 2 diabetes were highlighted as frequent comorbidities. Cognitive impairment in schizophrenia, assessed by the Brief Assessment of Cognition in Schizophrenia, indicated severe functional deficits with a Z-score of -2.1. Issues related to long-term hospitalization, including social isolation and inadequate post-discharge support, were also reported. Interventions aimed at improving cognitive function, fostering self-care, and strengthening community cooperation were identified as key factors in reducing early readmission rates. Caregivers experienced significant productivity losses, particularly due to presenteeism, leading to an estimated annual loss of JPY 2.4 million. The hand search further revealed a lack of stakeholder-driven initiatives to address the comprehensive burdens of schizophrenia, such as awareness campaigns, educational programs, and multidisciplinary approaches. This review underscores the multifaceted burdens of schizophrenia in Japan, emphasizing the urgent need for coordinated, evidence-based countermeasures involving multiple stakeholders, including patients, caregivers, healthcare professionals, and policymakers. To reduce burdens and improve healthcare, further research is needed to bridge the gap between required interventions and stakeholder engagement.