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Symptoms
By Mayo Clinic staffThe symptoms of schizophrenia also can be attributed to other mental illnesses, and no one symptom can pinpoint a diagnosis of schizophrenia. In men, schizophrenia symptoms typically start in the teens or 20s. In women, schizophrenia symptoms typically begin in the 20s or early 30s. It's uncommon for children to be diagnosed with schizophrenia and rare for those older than 40.
Signs and symptoms of schizophrenia generally are divided into three categories — positive, negative and cognitive.
Positive symptoms
In schizophrenia, positive symptoms reflect an excess or distortion of normal functions. These active, abnormal symptoms may include:
- Delusions. These beliefs are not based in reality and usually involve misinterpretation of perception or experience. They are the most common of schizophrenic symptoms.
- Hallucinations. These usually involve seeing or hearing things that don't exist, although hallucinations can be in any of the senses. Hearing voices is the most common hallucination among people with schizophrenia.
- Thought disorder. Difficulty speaking and organizing thoughts may result in stopping speech midsentence or putting together meaningless words, sometimes known as "word salad."
- Disorganized behavior. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation.
Negative symptoms
Negative symptoms refer to a diminishment or absence of characteristics of normal function. They may appear months or years before positive symptoms. They include:
- Loss of interest in everyday activities
- Appearing to lack emotion
- Reduced ability to plan or carry out activities
- Neglect of personal hygiene
- Social withdrawal
- Loss of motivation
Cognitive symptoms
Cognitive symptoms involve problems with thought processes. These symptoms may be the most disabling in schizophrenia, because they interfere with the ability to perform routine daily tasks. A person with schizophrenia may be born with these symptoms, but they may worsen when the disorder starts. They include:
- Problems with making sense of information
- Difficulty paying attention
- Memory problems
Affective symptoms
Schizophrenia also can affect mood, causing depression or mood swings. In addition, people with schizophrenia often seem inappropriate and odd, causing others to avoid them, which leads to social isolation.
When to see a doctor
People with schizophrenia often lack awareness that their difficulties stem from a mental illness that requires medical attention. So it usually falls to family or friends to get them help.
Helping someone who may have schizophrenia
If you think someone you know may have symptoms of schizophrenia, talk to him or her about your concerns. Although you can't force someone to seek professional help, you can offer encouragement and support and help your loved one find a qualified doctor or mental health provider.
If your loved one poses a danger to self or others or can't provide his or her own food, clothing or shelter, you may need to call the police or other emergency responders for help. In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state. You can contact community mental health agencies or police departments in your area for details.
Suicidal thoughts
Suicidal thoughts and behavior are common among people with schizophrenia. If you suspect or know that your loved one is considering suicide, seek immediate help. Contact a doctor, mental health provider or other health care professional.
- Understanding schizophrenia and recovery. National Alliance on Mental Health. http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23036. Accessed Oct. 22, 2009.
- Jibson M. Schizophrenia: Diagnostic evaluation and treatment. http://www.uptodate.com/home/index.html. Accessed Oct. 22, 2009.
- Jibson M. Schizophrenia: Clinical presentation, epidemiology and pathophysiology. http://www.uptodate.com/home/index.html. Accessed Oct. 22, 2009.
- Meltzer H, et al. Schizophrenia. In: Ebert M, et al. Current Diagnosis & Treatment: Psychiatry. 2nd ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3284037. Accessed Oct. 23, 2009.
- Let's talk facts about schizophrenia. American Psychiatric Association. http://healthyminds.org/Main-Topic/Schizophrenia.aspx?css=print. Accessed Oct. 22, 2009.
- Mental health medications. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml. Accessed Oct. 22, 2009.
- Van Os J, et al. Schizophrenia. Lancet. 2009;374:635.
