Schizophrenia (SCZ) is most likely to develop in young adulthood. Using data from a single state, we describe the demographic and clinical characteristics of young adults in the time period prior to initial SCZ diagnosis.
The CO-APCD is a comprehensive source of health care insurance claims information tracking 4 million covered lives across commercial health insurance, Medicare, and Medicaid. Using data from 2012-2019, we identified young adults (18-34 years) with ‚≥ 1 inpatient or 2+ outpatient diagnoses of SCZ (ICD-9: 295.xx;ICD-10: F20.xx, F25.xx). The distribution of first diagnosis dates for the SCZ cohort was applied to a 25% random sample of 18-34 year-olds without SCZ (non-SCZ) to compare their 12-month baseline demographic and clinical characteristics.
A total of 3,774 SCZ and 249,658 non-SCZ patients were identified. Mean ages were similar at 26 years, with more males in the SCZ group (64.3% vs 42.4%). The SCZ cohort had higher rates of Medicaid use in the year prior to diagnosis than the non-SCZ cohort (85.6% vs 50.1%). Among the medical and psychiatric disorders examined, SCZ patients had higher rates on 15 of 29 medical and 22 of 23 psychiatric disorders compared to the non-SCZ cohort. The SCZ cohort was also more likely to be prescribed any psychiatric medication compared to the non-SCZ cohort (68.4% vs 19.4%).
Young adults with schizophrenia have a higher medical and mental health disease burden compared to young adults in the general population. This burden is present even before SCZ is formally diagnosed.