The cause of schizophrenia is unknown but it is associated with problems in brain structure and chemistry. Genetics may be a factor.
Schizophrenia does not develop because of one factor. You may have a combination of changes in your genetic background that could increase your chances of schizophrenia. This alone doesn't mean you'll develop the disease. Outside environmental factors such as stress, infection, or trauma may also increase this risk. However, there is no clear evidence that any one single environmental factor leads to schizophrenia.
Men typically develop symptoms in their late teens or early twenties. Schizophrenia in women tends to occur in their twenties or thirties. In rare cases, schizophrenia starts in childhood.
Symptoms often appear slowly. Early signs may include difficulty with relationships, school, or work. The symptoms may occur in a matter of weeks, but most of the time they tend to become more disturbing or bizarre over a period of 6 months or longer.
Positive symptoms are behaviors that are not generally seen in healthy people. They may lose touch with reality with:
Hallucinations—seeing or hearing things/voices that are not there
Delusions—strong but false personal beliefs that are not based in reality
Negative symptoms are associated with breaks in normal emotions and behaviors such as:
Emotional flatness—flat speech, lack of facial expression, and general disinterest and withdrawal
Reduced feelings of pleasure
Difficulty starting and continuing activities
Cognitive symptoms are changes in memory and thinking such as:
Poor ability to understand information and make decisions based on it
Difficulty using information immediately after learning it
You, or a loved one or caregiver, will be asked about your symptoms and medical and mental health history. A physical exam will be done. A psychological exam may also be done.
It will take some time to confirm a schizophrenia diagnosis. Tests may be done to rule out other conditions or lifestyle habits such as substance misuse that can cause similar symptoms. Schizophrenia is diagnosed when 2 or more of the following symptoms occur and reduce ability of day to day life:
Disorganized or catatonic behavior
Symptoms that disrupt normal emotions and behaviors—also known as negative symptoms
Schizophrenia is not curable, but symptoms can be reduced through treatment. Early, aggressive treatment can lead to better outcomes and may delay progression of schizophrenia to
Hospitalization may be required during acute episodes. Symptoms are usually controlled with antipsychotic medications. Talk to your doctor about the best treatment plan for you. Options may include one or more of the following:
Antipsychotics work by blocking certain chemicals in the brain. This helps control the abnormal thinking that occurs in people with schizophrenia. Determining a drug plan can be a complicated process. Often medications or dosages need to be changed until the right balance is found. This can take months or even years. The right balance of medication will have the least amount of side effects possible with the greatest benefit.
It is important to continue taking the medication even if you are feeling better. Symptoms will return once the medication has been stopped. A long-acting injection instead of daily pills may be used if you have difficulty taking regular medication.
Antipsychotics also have side effects that may make it difficult to stick to a medication routine. Common side effects include:
Slow and stiff movements
atypical antipsychotics have fewer side effects and are better tolerated over long periods of time. However, these medications may cause significant weight gain, high blood sugar, and
Schizophrenia. National Institute of Mental Health website. Available at:
https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Updated February 26, 2016. Accessed april 18, 2018.
4/29/2016 DynaMed Plus Systematic Literature Surveillance ...(Click grey area to select URL) Stafford MR, Jackson H, Mayo-Wilson E, Morrison AP, Kendall T. Early interventions to prevent psychosis: systematic review and meta-analysis. BMJ. 2013;346:f185.
Last reviewed March 2018 by
EBSCO Medical Review Board
Adrian Preda, MD Last Updated: 4/17/2018