Schizophrenia
A serious, long-term mental illness that affects how a person thinks, perceives and feels, and one that many people recover from with treatment. This page covers what it is, when it usually begins, the early signs, what raises the risk, and where to find reliable help.
What this adds up to
People stop treatment for reasons that can be measured. Sensus measures them every four weeks, in the person’s own words and a family member’s, and puts them in front of the clinician, so the conversation about a medicine can happen before the decision to stop it.
The World Health Organization groups the symptoms into three kinds.1
Positive symptoms
Persistent delusions, hallucinations, the feeling that one’s thoughts are being controlled, and disorganized thinking and behaviour.
Negative symptoms
Limited speech, restricted emotional expression, loss of interest and motivation, and social withdrawal.
Cognitive symptoms
Problems with memory, attention and solving problems, which can make work, study and daily life harder.
Mood matters too. Depression and anxiety are common alongside schizophrenia, which is why the Feelings part runs at every sitting.
0.25–0.64%
The range of estimates for schizophrenia and related psychotic disorders in the United States.
National Institute of Mental Health228.5 years
The estimated average potential life lost in the US. WHO notes that most early deaths are from heart, metabolic and infectious disease.
NIMH2; WHO11 in 3
At least one in three people with schizophrenia will be able to fully recover. Yet only 29% of people with psychosis receive specialist mental health care.
World Health Organization1An estimated 4.9% of people with schizophrenia die by suicide, far more than in the general population, and the risk is highest early in the illness.2
Most often in late adolescence or early adulthood, and earlier in men than in women.
Bands show the typical onset windows reported by NIMH and NAMI; they are approximate and vary between sources.23
| Typical onset | Source | |
|---|---|---|
| Men | Late adolescence to the early twenties | NIMH; NAMI (“late teens to the early 20s”) |
| Women | Early twenties to early thirties (NIMH); late twenties to early thirties (NAMI) | NIMH; NAMI |
| Women, later in life | A second, smaller rise after about age 40–45, around perimenopause, when falling estrogen may remove some protection | Review, Archives of Women’s Mental Health 2023 |
| Uncommon | Diagnosis before age 12 or after age 40 | NAMI |
| Late and very late onset | Onset after 40 is termed late-onset schizophrenia; after 60, very-late-onset schizophrenia-like psychosis | International consensus, 20005 |
The second rise in women matters for care. Symptoms that begin or return in a woman’s forties are worth discussing with her clinician with this in mind.
Symptoms rarely appear overnight.
Most people go through a period, often called the prodrome, of gradual change before the first psychotic episode. NAMI lists signs such as:3
Each of these is common on its own, especially in teenagers, and none of them means a person is developing schizophrenia. Several together, worsening over time, are a reason to talk to a doctor.
No single cause. Several factors work together.3
| Factor | What is known |
|---|---|
| Genes | The likelihood is more than six times higher with a close relative who has schizophrenia. Most people with a relative who has it never develop it. |
| Before birth | Exposure to viruses or malnutrition before birth increases the risk. |
| Brain chemistry | Problems with brain chemicals including dopamine and glutamate. Most antipsychotic medicines act on dopamine. |
| Cannabis | Smoking marijuana increases the risk of psychotic episodes, especially when use begins young and is frequent. |
If you or someone you know is in danger right now, do not wait. Call or text 988 (Suicide & Crisis Lifeline), or call 911 in an emergency. The NAMI HelpLine is 1-800-950-6264.
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