Schizophrenia: Symptoms, Causes, Treatment, and Prognosis

How we reviewed this article: · Healthline

Key takeaways

Schizophrenia is a chronic mental health condition affecting less than 1% of the global population, with males typically showing symptoms in their late teens or early 20s and females in their late 20s or early 30s.

Common symptoms include hallucinations, delusions, paranoia, reduction in speaking, social isolation, and difficulty completing normal everyday activities.

While there’s no cure for schizophrenia, treatments include medications, psychosocial intervention, and vocational rehabilitation to help manage symptoms.

People with schizophrenia experience distortions of reality, often in the form of delusions or hallucinations.

Although exact estimates are difficult to obtain, researchers estimate that schizophrenia affects less than

1%

of the global population.

Misconceptions about this disorder are common. For example, some people think schizophrenia creates a “split personality.” In fact, schizophrenia and split personality — properly termed

dissociative identity disorder

— are two different disorders.

Schizophrenia can occur in people of all ages. According to the

American Psychiatric Association

, men often develop symptoms in their late teens or early 20s. Women tend to show signs in their late 20s and early 30s. A

2022 report

states that young men with cannabis use disorder are at the highest risk of developing schizophrenia.

Here’s what you need to know about this mental health condition.

Early symptoms

Symptoms of this disorder commonly appear in the teenage years and early 20s. At these ages, the earliest symptoms may get overlooked because they mirror certain “typical” adolescent behaviors.

Early symptoms can include:

isolating oneself from friends and family

changing friends or social groups

a change in focus and concentration

sleeping problems

irritability and agitation

difficulties with schoolwork, or low academic performance

anxiety

vague suspiciousness

odd ideas

feeling different from others

When it comes to more advanced symptoms, these tend to fall into three distinct categories: positive symptoms, negative symptoms, and cognitive symptoms.

The terms “positive” and “negative” have different connotations here: “Positive” symptoms mean added thoughts or actions to one’s typical experience. “Negative” symptoms are the absence of typical behaviors.

Positive symptoms

Positive symptoms of schizophrenia aren’t typical in individuals without schizophrenia or other types of severe mental illness. These behaviors include:

Hallucinations:

Hallucinations

are experiences that appear real but are created by your mind. They include seeing things, hearing voices, or smelling things that others around you don’t experience.

Delusions: A delusion occurs when you believe something despite evidence or facts to the contrary.

Paranoia: Paranoia is when someone is unusually distrustful of others or firmly believes they are being followed or persecuted.

Negative symptoms

Negative symptoms of schizophrenia interrupt a person’s typical emotions, behaviors, and abilities. These symptoms include:

reduction in speaking

odd emotional responses to situations

a lack of emotion or expressions

loss of interest or excitement for life

social isolation

trouble experiencing pleasure

difficulty beginning or following through with plans

difficulty completing normal everyday activities

Cognitive symptoms

Cognitive symptoms are labeled as such because they illustrate that someone is having trouble with certain mental functions. These symptoms include:

disorganized thinking or speech, such as when a person changes topics rapidly when speaking or uses made-up words or phrases

forgetfulness

disorganized thinking, such as trouble focusing or paying attention

impaired “executive functioning,” or understanding information and using it to make decisions

problems learning information and using it

Symptoms of schizophrenia can vary in severity and type. They may worsen if an individual is experiencing heightened stress, using substances, or is not taking their prescribed medications correctly.

The exact cause of schizophrenia is unknown. Medical researchers believe several factors can contribute, including:

biological

genetic

environmental

Research

suggests that imaging tests completed on people with schizophrenia may show abnormalities in certain brain structures.

Risk factors

Even though it’s still not known what causes schizophrenia, researchers believe genetics may play a role. People with a family history of schizophrenia have a

higher risk

of developing this disorder.

Other risk factors for schizophrenia may

include

:

having exposure to toxins, a virus, or malnutrition before birth or during infancy

using mind-altering drugs

living in a highly stressful situation

taking mind-altering drugs in adolescence or young adulthood

Schizophrenia is a serious mental illness that should not be ignored or left untreated. The condition increases the risk of serious complications, such as:

self-injury or suicide

anxiety

phobias

depression

alcohol or drug misuse

family problems

Schizophrenia can also make it difficult to work or attend school. If you can’t work or support yourself financially, there’s a higher risk of a lower quality of life.

There isn’t a single test to diagnose schizophrenia. A complete psychiatric exam can help healthcare professionals make a diagnosis. A psychiatrist or mental health professional can do this.

At your appointment, expect to answer questions about your:

medical history

mental health

family medical history

Your healthcare professional may conduct the following:

a physical exam

blood work

imaging tests, including an

MRI

or

CT scan

Sometimes, there can be other reasons for your symptoms, even though they may be similar to those of schizophrenia. These reasons may include:

substance use

certain medications

other mental health conditions

Your healthcare team may diagnose schizophrenia if you’ve had at least two symptoms for a 1-month period. These symptoms must include:

hallucinations

delusions

disorganized speech

There’s

no cure for schizophrenia

. Current treatments focus on managing or reducing the severity of symptoms.

It’s important to get treatment from a psychiatrist or mental health professional who has experience treating people with this disorder. You may also work with a social worker or a case manager, too.

Possible treatments include the following:

Medications

hallucinations

delusions

Psychosocial intervention

Another treatment option for schizophrenia is psychosocial intervention. This includes individual therapy to help you cope with stress and your diagnosis.

Social training can improve your social and communication skills.

Vocational rehabilitation

Vocational rehabilitation can provide you with the skills you need to return to work. It may make maintaining a regular job easier.

Family support and education

If you or someone you care about has received a diagnosis of schizophrenia, having support from family and friends can help lower stress and create a feeling of inclusion. There are educational programs available for family members that can help everyone spot the symptoms and provide support when needed.

A diagnosis of schizophrenia is common in people in their teens and early 20s. Although less common, it can begin earlier. When symptoms occur before age 13 years, the condition is sometimes called early onset or

childhood schizophrenia

.

Diagnosing this condition is difficult. Behavior changes aren’t unusual as children and teens develop. Plus, some of the most common symptoms of this mental health disorder also show up in other conditions. These include:

depression

bipolar disorder

attention disorders

Symptoms of childhood schizophrenia include:

unusual fears or anxieties (paranoia)

sleeping problems

mood changes

hearing voices or seeing things (hallucinations)

decreased attention to self-care

sudden changes in behavior

deterioration in academic performance

odd beliefs or thinking

It’s important to separate the behaviors that may occur in growing children and teenagers with symptoms of a serious mental health condition.

However, if you are concerned that your child has acquired some new, worrying behaviors, it’s essential to talk with a mental health professional as soon as you can.

No matter what the issue is, a professional can support you to make the best decision for your family.

Schizophrenia and

psychosis

may be confused with one another, but they’re not the same. One is a mental health condition, and the other is a symptom or group of symptoms.

Psychosis is one element or symptom of several mental health disorders, including schizophrenia. Psychosis can also occur in people with no other mental health symptoms.

Although psychosis can occur in people with schizophrenia, not everyone with this disorder will experience psychosis. If you or someone you know is experiencing symptoms of psychosis, seek treatment immediately.

Schizophrenia and

bipolar disorder

are both chronic mental health conditions. They may share some characteristics, but there are distinct differences.

Bipolar disorder causes strong mood changes. These changes switch between

mania

and

depression

.

During these

episodes

, it’s possible that someone with bipolar disorder will experience hallucinations or delusions, especially in a manic episode. Experiencing

psychosis

along with mood changes may make completing everyday tasks harder.

Likewise, people with schizophrenia may experience hallucinations or delusions, but they’re also very likely to experience disorganized thinking and speech. Unlike someone with bipolar disorder during a manic episode, the symptoms of psychosis aren’t accompanied by mania.

No medical test can determine which condition you have. Instead, your healthcare professional may refer you to a mental health professional who will perform a comprehensive psychiatric evaluation and order some tests to help rule out possible medical causes. These tests could include blood tests, imaging tests, and drug screening tests.

While a schizophrenia diagnosis can come with an increased risk of mortality due to co-occurring conditions and the risk of suicide, proper treatment can help an individual live a productive and happy life.

Like many chronic conditions, a person’s outlook depends on a lot of personal factors, including how early a diagnosis was made, how much an individual is able and willing to follow a treatment plan, and their support system.

Schizophrenia is typically diagnosed in people in their

late teens to early 30s

.

Men tend to show symptoms earlier, and cannabis use disorder

may be

a contributing factor. Men also receive a diagnosis earlier than others, between

late adolescence and their early 20s

.

Women tend to receive a diagnosis later than men, from their

early 20s to early 30s

.

Research suggests that schizophrenia occurs in

less than 1%

of people. It affects

more than 24 million

people around the world.

Worldwide, schizophrenia is

one of the top

causes of disability.

Almost half

of people with schizophrenia also have other mental health issues.

There’s no real way to prevent schizophrenia. Still, identifying who’s at risk and how to prevent the disorder from occurring in at-risk individuals has been an important focus of researchers in recent years.

According to the World Health Organization (WHO),

at least one-third

of people with schizophrenia experience a complete remission of symptoms. To get on the road to improvement, it’s important to:

learn about your condition

understand the risk factors

follow your healthcare team’s treatment plan

Schizophrenia symptoms can go away for a while and then return, but it’s possible to enjoy a healthy, symptom-free life. Following your healthcare professional’s recommendations will improve your outlook.