Schizophrenia
Psychosis - schizophrenia; Psychotic disorders - schizophreniaSchizophrenia is a mental disorder that makes it hard to tell the difference between what is real and not real.
It also makes it hard to think clearly, have normal emotional responses, and act normally in social situations.
Causes
Schizophrenia is a complex illness. Mental health experts are not sure what causes it. Genes may play a role.
Schizophrenia occurs in just as many men as women. It usually begins in the teen or young adult years, but it may begin later in life. In women, it tends to begin slightly later.
Schizophrenia in children usually begins after age 5. Childhood schizophrenia (younger than 13) is rare and can be hard to tell apart from other developmental problems.
Symptoms
Symptoms usually develop slowly over months or years. The person may have many symptoms, or only a few.
People with schizophrenia may have trouble keeping friends and jobs. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors.
Anxiety
Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control ...
Read Article Now Book Mark ArticleDepression
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...
Read Article Now Book Mark ArticleSuicidal thoughts or behaviors
Suicide is the act of taking one's own life on purpose. Suicidal behavior is any action that could cause a person to die, such as taking a drug over...
Read Article Now Book Mark ArticleEarly symptoms may include:
- Irritable or tense feelings
- Trouble concentrating
- Trouble sleeping
As the illness continues, the person may have problems with thinking, emotions, and behavior, including:
- Hearing or seeing things that are not there (hallucinations)
Hallucinations
Hallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.
Read Article Now Book Mark Article - Isolation
- Reduced emotions in tone of voice or expression of face
- Problems with understanding and making decisions
- Problems paying attention and following through with activities
- Strongly held beliefs that are not real (delusions)
- Talking in a way that does not make sense
Exams and Tests
There are no medical tests to diagnose schizophrenia. A psychiatrist should examine the person and make the diagnosis. The diagnosis is made based on an interview of the person and family members.
The psychiatrist will ask about the following:
- How long symptoms have lasted
- How the person's ability to function has changed
- What the person's developmental background was like
- About the person's genetic and family history
- How well medicines have worked
- Whether the person has problems with substance abuse
- Other medical conditions the person has
Brain scans (such as CT or MRI) and blood tests may be used to check for other conditions that have similar symptoms.
CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
Read Article Now Book Mark ArticleMRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Read Article Now Book Mark ArticleTreatment
During an episode of schizophrenia, the person may need to stay in the hospital for safety reasons.
MEDICINES
Antipsychotic medicines (antipsychotics) are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help regulate symptoms.
These medicines can cause side effects, but many side effects can be managed. Side effects should not prevent the person from getting treated for this serious condition.
Common side effects from antipsychotics may include:
- Dizziness
- Feelings of restlessness or jitteriness
- Sleepiness (sedation)
- Slowed movements
- Tremor
Tremor
A tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...
Read Article Now Book Mark Article - Weight gain
- Diabetes
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - High cholesterol
Long-term use of antipsychotics may increase the risk for a movement disorder called tardive dyskinesia. This condition causes repeated movements that the person cannot control. Contact your health care provider right away if you think you or your family member may have this condition due to a medicine.
Tardive dyskinesia
Tardive dyskinesia (TD) is a disorder that involves involuntary movements. Tardive means delayed and dyskinesia means abnormal movement.
Read Article Now Book Mark ArticleWhen schizophrenia does not improve with antipsychotic medicines, other medicines may be tried.
Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotic medicines for life.
SUPPORT PROGRAMS AND THERAPIES
Support therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better in social and work situations. Job training and relationship-building classes are also important.
Family members and caregivers are very important during treatment. Therapy can teach important skills, such as:
- Coping with symptoms that continue, even while taking medicines
- Following a healthy lifestyle, including getting enough sleep and staying away from recreational drugs
- Taking medicines correctly and managing side effects
- Watching for the return of symptoms, and knowing what to do when they return
- Getting the right support services
Outlook (Prognosis)
The outlook is hard to predict. Most of the time, symptoms improve with medicines. But many people may have trouble functioning. They are at risk for repeated episodes, especially during the early stages of the illness. People with schizophrenia are also at increased risk for suicide.
People with schizophrenia may need housing, job training, and other community support programs. Those with the most severe forms of this disorder may not be able to live alone. They may need to live in group homes or other long-term, structured residences.
Symptoms are very likely to return when antipsychotic medicine is stopped.
Possible Complications
Having schizophrenia increases the risk for:
- Developing a problem with alcohol or illegal drugs. Using these substances increases the chances that symptoms will return.
Alcohol
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
Read Article Now Book Mark ArticleIllegal drugs
Substance use is the continued use of alcohol, illegal drugs, or the misuse of prescription or over-the-counter medicines with negative consequences....
Read Article Now Book Mark Article - Physical illness. This is due to an inactive lifestyle and side effects of medicines.
- Suicide.
When to Contact a Medical Professional
Contact your provider if you (or a family member):
- Hear voices telling you to hurt yourself or others
- Have the urge to hurt yourself or others
- Feel scared or overwhelmed
- See or hear things that are not there
- Feel that you cannot leave the house
- Feel that you are not able to care for yourself
If you are thinking about hurting yourself or others, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
Prevention
Schizophrenia cannot be prevented.
Symptoms may be prevented by taking medicine exactly as your provider instructed. Symptoms are likely to return if medicine is stopped.
Changing or stopping medicines should only be done by the provider who prescribed them.
References
American Psychiatric Association. Schizophrenia spectrum and other psychotic disorders. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.
Jauhar S, Johnstone M, McKenna PJ. Schizophrenia. Lancet. 2022;399(10323):473-486. PMID: 35093231 pubmed.ncbi.nlm.nih.gov/35093231/.
Lim C, Shreedhar P, Holt DJ, Freudenreich O. Psychosis and schizophrenia. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 27.
Substance Abuse and Mental Health Services Administration website. Schizophrenia. www.samhsa.gov/mental-health/schizophrenia. Updated April 24, 2023. Accessed September 1, 2024.
Schizophrenia - illustration
Schizophrenia is a group of psychotic disorders characterized by disturbances in perception, affect, behavior and communication lasting longer than 6 months (this includes psychotic behavior). The person suffering from schizophrenia has deteriorated occupational, interpersonal and self-supportive abilities.
Schizophrenia
illustration
Schizophrenia - illustration
Schizophrenia is a group of psychotic disorders characterized by disturbances in perception, affect, behavior and communication lasting longer than 6 months (this includes psychotic behavior). The person suffering from schizophrenia has deteriorated occupational, interpersonal and self-supportive abilities.
Schizophrenia
illustration
- Schizophrenia - InDepth(In-Depth)
Review Date: 7/17/2024
Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.