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Peer-reviewedCC BYNeuropsychiatric Disease and Treatment

Characterizing Self-Reported Negative Symptom-Related Experiences and Multilevel Burden in Schizophrenia: Evidence from the Medical Expenditure Panel Survey

  • Correll CU1
  • Patel R2
  • Singh T3
  • McBride K4
  • Mirza S4
  • Costantino H4
  • Xiang P
4 affiliations
  1. 1Psychiatry and Molecular Medicine
  2. 2US HEOR VDT
  3. 3HEOR
  4. 4Evidence Generation
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Abstract

Christoph U Correll,1– 6 Ravi Patel,7 Tavneet Singh,8 Kaitlyn McBride,8 Sana Mirza,8 Halley Costantino,8 Pin Xiang7 1Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; 2Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; 3Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Northwell Health, New Hyde Park, NY, USA; 4Department of Child and Adolescent Psychiatry, Charité – Universitätsmedizin Berlin, Berlin, Germany; 5German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany; 6Einstein Center for Population Diversity (ECPD), Berlin, Germany; 7Health Economics and Outcomes Research (HEOR), Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA; 8Health Economics and Outcomes Research (HEOR), BluePath Solutions, Los Angeles, CA, USACorrespondence: Sana Mirza, Health Economic and Outcomes Research (HEOR), BluePath Solutions, 1640 S Sepulveda Blvd. Ste. 207, Los Angeles, CA, USA, Email [email protected]: To estimate the prevalence and burden of proxy-defined experiential negative symptoms and characterize their associated burden among adults with schizophrenia in the US.Methods: Retrospective analyses of the Medical Expenditure Panel Survey (2004– 2022) were conducted to identify adults (≥ 18 years) with schizophrenia. Self-reported experiential negative symptom proxies were defined across three domains: avolition, anhedonia, and asociality using available MEPS survey items. Outcomes included demographic, clinical, and socioeconomic characteristics, healthcare resource utilization (HCRU) and expenditures, as well as humanistic and indirect burdens. Descriptive and comparative analyses were stratified by the presence of negative symptom proxies and weighted to generate nationally representative estimates, with expenditure reported in 2024 US dollars. State-level exploratory analyses examined burden among proxy-positive respondents in states with high schizophrenia prevalence.Results: Among 616,530 weighted participants with schizophrenia (mean age=47.5 years; male=53.2%), 71.3% met criteria for ≥ 1 experiential negative symptom proxy. Compared with individuals without negative symptoms, those with negative symptoms had statistically significantly more overall (3.2 vs 2.0; P< 0.001) and psychiatric (2.1 vs 1.2; P< 0.001) comorbidities, higher unemployment (79% vs 61%; P< 0.001), and greater reliance on Medicaid (65% vs 51%; P< 0.01). Proxy-positive participants also experienced statistically significantly higher healthcare resource and economic burden, including increased hospitalizations (25% vs 14% P< 0.05), emergency department visits (36% vs 20%; P< 0.05), and annual expenditures (&dollar;20,038 vs &dollar;13,502; P< 0.001), as well as poorer humanistic and functional outcomes (all P< 0.001). Exploratory state-level analyses revealed variation in demographics, healthcare use, and expenditures.Conclusion: Adults with schizophrenia who reported negative symptom proxies experienced greater clinical, socioeconomic, functional, and healthcare burden than those without these symptoms. They also had higher healthcare utilization and expenditures and poorer quality-of-life outcomes. These findings highlight the importance of recognizing negative symptom-related experiences and addressing the broader needs of this high-burden population.Keywords: negative symptoms, schizophrenia, medicaid, medical expenditure panel survey

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Cite

BibTeXRIS
BibTeX
@article{correll2026characterizing,
  title = {{Characterizing Self-Reported Negative Symptom-Related Experiences and Multilevel Burden in Schizophrenia: Evidence from the Medical Expenditure Panel Survey}},
  author = {Correll CU and Patel R and Singh T and McBride K and Mirza S and Costantino H and Xiang P},
  journal = {Neuropsychiatric Disease and Treatment},
  year = {2026},
  month = nov,
  url = {https://www.dovepress.com/characterizing-self-reported-negative-symptom-related-experiences-and--peer-reviewed-fulltext-article-NDT},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Characterizing Self-Reported Negative Symptom-Related Experiences and Multilevel Burden in Schizophrenia: Evidence from the Medical Expenditure Panel Survey
AU  - Correll CU
AU  - Patel R
AU  - Singh T
AU  - McBride K
AU  - Mirza S
AU  - Costantino H
AU  - Xiang P
PY  - 2026
DA  - 2026/11/08
JO  - Neuropsychiatric Disease and Treatment
UR  - https://www.dovepress.com/characterizing-self-reported-negative-symptom-related-experiences-and--peer-reviewed-fulltext-article-NDT
AB  - Christoph U Correll,1– 6 Ravi Patel,7 Tavneet Singh,8 Kaitlyn McBride,8 Sana Mirza,8 Halley Costantino,8 Pin Xiang7 1Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; 2Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; 3Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Northwell Health, New Hyde Park, NY, USA; 4Department of Child and Adolescent Psychiatry, Charité – Universitätsmedizin Berlin, Berlin, Germany; 5German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany; 6Einstein Center for Population Diversity (ECPD), Berlin, Germany; 7Health Economics and Outcomes Research (HEOR), Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA; 8Health Economics and Outcomes Research (HEOR), BluePath Solutions, Los Angeles, CA, USACorrespondence: Sana Mirza, Health Economic and Outcomes Research (HEOR), BluePath Solutions, 1640 S Sepulveda Blvd. Ste. 207, Los Angeles, CA, USA, Email [email protected]: To estimate the prevalence and burden of proxy-defined experiential negative symptoms and characterize their associated burden among adults with schizophrenia in the US.Methods: Retrospective analyses of the Medical Expenditure Panel Survey (2004– 2022) were conducted to identify adults (≥ 18 years) with schizophrenia. Self-reported experiential negative symptom proxies were defined across three domains: avolition, anhedonia, and asociality using available MEPS survey items. Outcomes included demographic, clinical, and socioeconomic characteristics, healthcare resource utilization (HCRU) and expenditures, as well as humanistic and indirect burdens. Descriptive and comparative analyses were stratified by the presence of negative symptom proxies and weighted to generate nationally representative estimates, with expenditure reported in 2024 US dollars. State-level exploratory analyses examined burden among proxy-positive respondents in states with high schizophrenia prevalence.Results: Among 616,530 weighted participants with schizophrenia (mean age=47.5 years; male=53.2%), 71.3% met criteria for ≥ 1 experiential negative symptom proxy. Compared with individuals without negative symptoms, those with negative symptoms had statistically significantly more overall (3.2 vs 2.0; P< 0.001) and psychiatric (2.1 vs 1.2; P< 0.001) comorbidities, higher unemployment (79% vs 61%; P< 0.001), and greater reliance on Medicaid (65% vs 51%; P< 0.01). Proxy-positive participants also experienced statistically significantly higher healthcare resource and economic burden, including increased hospitalizations (25% vs 14% P< 0.05), emergency department visits (36% vs 20%; P< 0.05), and annual expenditures (&dollar;20,038 vs &dollar;13,502; P< 0.001), as well as poorer humanistic and functional outcomes (all P< 0.001). Exploratory state-level analyses revealed variation in demographics, healthcare use, and expenditures.Conclusion: Adults with schizophrenia who reported negative symptom proxies experienced greater clinical, socioeconomic, functional, and healthcare burden than those without these symptoms. They also had higher healthcare utilization and expenditures and poorer quality-of-life outcomes. These findings highlight the importance of recognizing negative symptom-related experiences and addressing the broader needs of this high-burden population.Keywords: negative symptoms, schizophrenia, medicaid, medical expenditure panel survey
SN  - 1178-2021
ER  -