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Understanding the
symptoms of
schizophrenia
Medically reviewed by Nicole Washington,
DO, MPH — By Tim Newman and Ruth
Eagle — Updated on January 6, 2023

Age of onset Types Symptoms

Causes Without treatment Treatment
Diagnosis Summary

The symptoms of schizophrenia

usually appear in late adolescence
or early adulthood. They affect a
person’s speech, thinking,
emotions as well as social
interactions and other everyday
activities.

Schizophrenia is a fairly uncommon

condition, affecting around 0.25–0.64%  of
people in the United States. It can have a
profound impact  on a person’s life, as well
as the lives of those around them.

Schizophrenia is a lifelong condition, but

treatment can help manage the symptoms.

This article will look at the causes and

symptoms of schizophrenia and some of the
treatment options available.
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When does schizophrenia

typically develop?

Elena Karetnikova/EyeEm/Getty Images

The symptoms of schizophrenia usually

emerge when a person is in their late teens
or early 30s . They tend to develop earlier
in males than in females.

Sometimes, a person will start to show

unusual behaviors from childhood, but these
only become significant as they get older. In
others, the symptoms may appear suddenly.

Learn more about the average age of onset

for schizophrenia here.

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Types
The classifications and types of
schizophrenia have changed over the years.
Previously, health professionals may have
classified schizophrenia as one of the
following five types:

paranoid type

disorganized type

catatonic type

undifferentiated type

residual type

However, doctors no longer classify types of

schizophrenia. The Diagnostic and Statistical
Manual of Mental Disorders (DSM–5) is the
manual mental health professionals use to
diagnose mental health conditions. The
current version, DSM-V, no longer  uses
these categories. This is because health
experts noted that the previous types had
many overlapping features and symptoms.

Click here to learn more about the different

types of schizophrenia.
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Symptoms
Schizophrenia affects people in different
ways, but there are some common
symptoms. These include:

confused speech that is intact but hard

for others to interpret and understand

lack of facial expression

lack of emotional expression

lack of motivation

difficulty concentrating

psychosis, such as delusions and

hallucinations

Before experiencing these symptoms, a

person may appear:

out of sorts

anxious

to lack focus

The sections below will discuss some of the

main symptoms of schizophrenia in more
detail.

Delusions

A person experiencing delusions has a fixed

belief about something regardless of the
evidence.

For example, they may believe that:

They are very important.

Someone is pursuing them.

Others are attempting to control them

remotely.

They have extraordinary powers or

abilities.

Hallucinations

Some people experience hallucinations. The

most common type is hearing voices, but
hallucinations can affect all the senses. For
example, a person may also see, feel, taste,
or smell things that are not really there.

Confused thinking and speech

A person’s thinking, and speech, may jump

from one subject to another for no logical
reason. It may therefore be hard to follow
what the person is trying to say.

There may also be memory problems and

difficulty understanding and using
information.

Other symptoms

The symptoms listed above can also affect a

person’s:

Motivation: The person may neglect

everyday activities, including self-care.
They may also experience catatonia,
during which they can barely talk or
move.

Emotional expression: The person may

respond inappropriately or not at all on
sad or happy occasions.

Social life: The person may withdraw

socially, possibly through fear that
somebody will harm them.

Communication: The person’s unusual

thought and speech patterns can make
it difficult for them to communicate with
others.

Many people with schizophrenia do not

realize that they are unwell. Hallucinations
and delusions can seem very real to a
person who is experiencing them. This can
make it hard to convince the individual to
seek treatment or take medication. They
may fear the side effects or believe that
medication will harm them.

Schizophrenia usually appears in a person’s

late teens or older, but it can also affect
children.

Learn more about the symptoms of

schizophrenia here.

Causes
Schizophrenia likely develops  when
specific genetic and environmental factors
combine.

For example, the following factors might all

contribute to the development of
schizophrenia:

Genetic inheritance

If there is no history of schizophrenia in a

family, the chances of developing it are low.
However, a person’s risk rises if one of their
parents has a diagnosis of schizophrenia.

A chemical imbalance in the brain

Schizophrenia appears to develop when

there is an imbalance of the neurotransmitter
dopamine and possibly serotonin in the
brain.

Environmental factors

Environmental factors that may increase the

risk of schizophrenia include:

trauma during birth

malnutrition before birth

viral infections

psychosocial factors, such as trauma

Certain drugs and medications

In 2017, scientists found evidence to suggest

that some substances in cannabis can
trigger schizophrenia in those susceptible to
it.

Others, however, have suggested that

having schizophrenia may make a person
more likely to use cannabis in the first place.

Learn about cannabis and schizophrenia

here.

What happens if schizophrenia

is untreated?
People with untreated schizophrenia are
more likely  to self-harm and be violent
toward others than those who have received
treatment.

A 2015 study in China compared outcomes

for 123,572 people with treated and
untreated schizophrenia 14 years after they
received a diagnosis.

After 14 years, people who did not receive

treatment were more likely to:

be older

have fewer family members

be homeless

have died from other causes

be unmarried

live alone

be without a caregiver

have poorer family attitudes

The researchers also found that 57.3% of

treated people experienced partial or
complete remission, compared to 29.8% in
the never-treated group.

If someone is showing symptoms of

schizophrenia, it is important to get prompt
treatment.

Learn about treatment-resistant

schizophrenia here.
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tools to manage stress & improve
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Treatment
Schizophrenia is a lifelong condition, but
effective treatment  can help a person
manage the symptoms, prevent relapses,
and avoid hospitalization.

Each person’s experience will differ, and a

doctor will tailor the treatment to suit the
individual.

Some potential treatment options include:

Antipsychotic drugs. People can take

these daily or less frequently if they opt
for injectable medications, which can
last up to 3 months, depending on the
medication.

Counseling. Mental health counseling

can help people develop coping skills
and pursue their life goals.

Coordinated special care. This

integrates medication, family
involvement, and education services in
a holistic approach.

Some common medications for

schizophrenia include :

risperidone (Risperdal)

olanzapine (Zyprexa)

quetiapine (Seroquel)

ziprasidone (Geodon)

clozapine (Clozaril)

haloperidol (Haldol)

That said, many older drugs may have

adverse effects, including neurological
symptoms. Newer medications typically have
different side effects, such as weight gain.

It is essential for a person to continue with

their treatment plan, even if the symptoms
improve. If a person stops taking medication,
the symptoms may return.

Learn about antipsychotic drugs for

schizophrenia here.

Diagnosis
There is no diagnostic test to assess
schizophrenia. A doctor will diagnose it by
observing how the person behaves. They
will also ask about their history of physical
and mental health.

That said, they may recommend some tests

to rule out other possible causes of the
symptoms, such as a tumor, brain injury, or
another mental health condition, such as
bipolar disorder.

Diagnostic criteria

To diagnose schizophrenia, a doctor will use

the criteria  from the DSM-5. This manual
provides criteria for diagnosing a wide range
of mental health conditions.

According to the criteria, a person must have

at least two of the following symptoms for a
month:

1. delusions

2. hallucinations

3. disorganized speech

4. grossly disorganized or catatonic

behavior

5. negative symptoms, such as lack of

speech, emotional flatness, or lack of
motivation

At least one of these must be 1, 2, or 3.

They must also experience considerable

impairment in their ability to function in
school or at work, interact with others, or
carry out self-care tasks.

They must also have symptoms that persist

for 6 months or more. The symptoms must
also not be due to another health condition,
a prescribed medication, or the use of other
substances.

The symptoms must also not be due to

another health condition, a prescribed
medication, or the use of other substances.

Learn about the stages of schizophrenia

here.
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Summary
Schizophrenia is a long-term condition that
can profoundly affect a person’s ability to
function. These effects can also affect the
people around them.

Treatment is available that can help a person

manage their symptoms. People with
schizophrenia will also benefit from the
support of their family, friends, and
community services.

Anyone caring for someone with

schizophrenia can help by learning how to
spot the onset of an episode, encouraging
the person to adhere to their treatment plan,
and supporting them through their
experience.

Read the article in Spanish.

Last medically reviewed on August 31, 2022

Mental Health Schizophrenia

Psychology / Psychiatry

How we reviewed this article:

SOURCES

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