Schizophrenia is a chronic, severe, disabling brain disorder. It interferes with the way a person interprets reality. People with schizophrenia may:
- Hear voices or see things that others do not
- Become paranoid that people are plotting against them
- Experience cognitive deficits
- Withdraw socially
These and other symptoms make it difficult for people with schizophrenia to have positive relationships with others.
Regions of the Brain
The cause of schizophrenia is unknown but it is associated with problems in brain structure and chemistry. There may be some genetic role.
Schizophrenia does not develop because of one factor. You may have a gene that increases your chance of schizophrenia, but you may not develop the disease based on your environment. Environment means any outside factor like stress or infection.
Factors that may increase your chance of schizophrenia include:
- Having a parent or sibling with schizophrenia
- Marijuana use or other drug use
- Father being of older age
- Other factors, like problems during pregnancy or birth such as infection
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, it is seen in childhood.
Symptoms often appear slowly. They may become more disturbing and bizarre over time or occur in a matter of weeks or months.
Symptoms may include:
- Hallucinations—seeing or hearing things/voices that are not there
- Delusions—strong but false personal beliefs that are not based in reality
- Disorganized thinking
- Disorganized speech—lack of ability to speak in a way that makes sense
- Catatonic behavior—slow movement, repeating rhythmic gestures, pacing, walking in circles, refusal to do things, repetitive speech
- Emotional flatness—flat speech, lack of facial expression, and general disinterest and withdrawal
- Inappropriate laughter
- Poor hygiene and self-care
Your doctor will ask you about your symptoms and medical history. A physical exam will be done.
Schizophrenia is diagnosed by certain symptoms that:
- Exist most of the time during a period of one month
- Cause a decreased level of functioning
- Continue for at least 6 months (certain symptoms)
The doctor will rule out other causes, such as drug use, physical illness, or other mental health conditions.
Schizophrenia is not curable, but it is highly treatable. 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
- Facial tics
- Protruding tongue
Medications called atypical antipsychotics have fewer side effects and are better tolerated over long periods of time. However, these medications may cause weight gain, high blood sugar, and high cholesterol.
Medications for Coexisting Conditions
- Anti-anxiety medications
- Mood stabilizers
There are no current guidelines to prevent schizophrenia because the cause is unknown. Studies show that early, aggressive treatment leads to better outcomes.
National Institute of Mental Health
World Fellowship for Schizophrenia and Allied Disorders
Canadian Psychiatric Association
Mental Health Canada
Schizophrenia. American Psychiatric Association website. Available at: http://www.psychiatry.org/schizophrenia. Accessed April 3, 2013.
Schizophrenia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 13, 2013. Accessed April 3, 2013.
Schizophrenia. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Updated April 2, 2013. Accessed April 3, 2013.
Schizophrenia in children and adolescents. National Alliance on Mental Illness website. Available at: http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=103175. Updated July 2010. Accessed August 28, 2012.
Last reviewed January 2015 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.