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Zusammenfassung Anliegen: Analyse der direkten Krankheitskosten bei persistierender Positivsymptomatik psychotischer Erkrankungen. Methode: Analyse von 3-Monats-Kosten bei 330 Patienten auf Grundlage von Befragungsdaten. Ergebnisse: Die durchschnittlichen direkten Kosten betrugen 7065Euro (63% psychiatrisch stationar, 17% Wohnbetreuung, 8% komplementare Angebote) und waren mit der negativen Subskala der PANSS (+2484Euro/Punkt, p<0,001) und dem Erfahren von weniger als einem Sozialkontakt pro Woche (-2272Euro, p=0,003) assoziiert. Schlussfolgerungen: Persistierende Positivsymptomatik ist mit hohen direkten Kosten verbunden. Abstract Objective: To analyze direct costs and cost determinants in psychotic patients with persistent positive symptoms (PPS). Methods: A total of 330 patients with PPS were recruited via 6 university clinics and interviewed about service utilization in the previous 3 months. After monetary valuation, costs were analyzed via generalized linear mixed models with gamma distribution and log-link function to identify determinants of direct costs. Results: The mean costs were 7,065Euro and resulted predominantly from psychiatric hospital care (63%), assisted living (17%) and complementary services (8%). We found statistically significant associations between direct costs and an increasing score of the negative subscale of the Positive and Negative Syndrome Scale (+2,484Euro per point, p<0.001) and experiencing less than one social contact per week (-2,272Euro, p=0.003). Conclusion: PPS incurred substantial direct costs which primarily resulted from hospital treatment, and were strongly associated with symptom severity.