Overview

Schizophrenia is a mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions. Although the course of schizophrenia varies among individuals, schizophrenia is typically persistent and can be both severe and disabling. The term “paranoid schizophrenia” is an outdated name for a subtype of schizophrenia. Experts no longer use or recognize this term. Instead, experts recognize schizophrenia as a specific disease, which is part of a spectrum of related conditions that involve psychosis. Schizophrenia usually happens at different ages depending on biological sex, but it doesn’t happen at different rates. It usually starts between ages 15 and 25 for males and between 25 and 35 for females. Schizophrenia in children is rare but possible, and these cases are usually much more severe. Experts estimate about 85 people out of every 10,000 will develop this condition at some point in their lifetime. Getting the proper treatment early is the best way to improve your chances of managing the illness. Some people can recover from schizophrenia entirely and never have it return. You may need to stay on medication for a long time, possibly even for life. People with schizophrenia also have a higher risk of dying by suicide, which means treatment can be life-saving, not just helpful.

Symptoms

The key symptoms of schizophrenia are:

• Delusions.
• Hallucinations.
• Disorganized or incoherent speech.
• Disorganized or unusual behavior.
• Negative symptoms.

Delusions and hallucinations are the two symptoms that can involve paranoia.

• Delusions. These are persistent false beliefs. A person who has a delusional belief usually won’t change their mind even if faced with strong evidence. Delusions involving paranoia are often “persecutory,” which means a person believes that someone is trying to harm them or negatively affect their life.
• Hallucinations. These are events a person imagines (usually in the form of something that a person hears or sees). A person who has a hallucination typically can’t tell that what they’re experiencing isn’t real. These commonly feed into delusions by giving the person additional “evidence” to confirm that someone is trying to harm or upset them.

Causes

The three main reasons that schizophrenia happens include:

• Chemical imbalances in your brain. The chemicals involved are those that your brain uses to communicate between brain cells.
• Congenital brain problems. These are problems that affect your brain’s development before you’re born.
• Communication disruptions between areas of the brain. Your brain relies on intricate networks of connections between its various areas. Experts suspect that schizophrenia happens because those connections deteriorate.

Experts believe several risk factors contribute to developing schizophrenia. Those risk factors include genetic mutations you inherit from one or both parents, exposure to certain chemicals or substances, complications during pregnancy and recreational drug use. However, experts have yet to uncover any confirmed triggers or causes for this condition.

Diagnosis and Tests

Usually a mental health specialist like a psychiatrist, diagnoses schizophrenia using a combination of tools and techniques. Some of the techniques involve analyzing your medical and personal history, asking you questions about your experiences and symptoms, and observing your behavior and actions.

Combining those methods is necessary because diagnosing schizophrenia requires the following:

• At least two of the five main symptoms.
• Main symptoms that have lasted at least one month, and overall effects that have lasted at least six months.
• Disruption in your social or work life.

The possible tests include:

• Imaging tests. These can include computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans and other imaging tests.
• Blood, urine and cerebrospinal fluid (spinal tap) tests. These tests look for chemical changes in bodily fluids, as well as heavy metal poisoning, infections and more.
• Brain activity testing. An electroencephalogram (EEG) analyzes and records the electrical activity in your brain, which can rule out seizures or epilepsy.

Management and Treatment

Schizophrenia is almost always treatable, but it isn’t curable. Some people can recover from schizophrenia entirely and never have it return. However, experts consider people in that situation “in remission” because there’s no way to predict if it will or won’t return. Schizophrenia treatment will center on managing your symptoms. You may need to stay on medication for a long time, possibly even for life. Psychotherapy, a kind of talk therapy, will likely also be a big part of the plan to help you understand and manage your symptoms.