Table of ContentsView AllTable of ContentsSchizophrenia: A Psychotic DisorderClinical SymptomsOther SymptomsSymptoms in Children and TeensPsychiatric AssessmentClosely Related ConditionsWhen to Consult a DoctorNext in Schizophrenia GuideCauses and Risk Factors of Schizophrenia
Table of ContentsView All
View All
Table of Contents
Schizophrenia: A Psychotic Disorder
Clinical Symptoms
Other Symptoms
Symptoms in Children and Teens
Psychiatric Assessment
Closely Related Conditions
When to Consult a Doctor
Next in Schizophrenia Guide
Close
The symptoms of schizophrenia can seem peculiar to people who observe them. Some common symptoms of schizophrenia include delusions, hallucinations, disorganized behavior, lack of emotion, reduced and disorganized speech, and memory problems.
However, when people areexperiencing symptoms, they may have little or no insight that their thoughts or behaviors are strange. The lack of insight can make schizophrenia very frustrating and frightening for loved ones.
Verywell / Cindy Chung
Schizophrenia is classified as a psychotic disorder, meaning a person becomes disconnected from reality.This disconnect will affect some combination of a person’s perceptions,thought processes, beliefs, and emotions. These symptoms may come and go episodically.
Three Phases of SchizophreniaSchizophrenia usually develops inthree phases:1) Aprodromal phasewhen changes in thoughts, feelings, and perceptions begin2) Anacute phasewhen psychotic symptoms appear3) Arecovery phasewhere support, medication, and therapy aid in improving the condition
Three Phases of Schizophrenia
Schizophrenia usually develops inthree phases:1) Aprodromal phasewhen changes in thoughts, feelings, and perceptions begin2) Anacute phasewhen psychotic symptoms appear3) Arecovery phasewhere support, medication, and therapy aid in improving the condition
Schizophrenia usually develops inthree phases:
Aprodromal phasewhen changes in thoughts, feelings, and perceptions begin
Anacute phasewhen psychotic symptoms appear
Arecovery phasewhere support, medication, and therapy aid in improving the condition
TheDiagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)is a clinical resource practitioners use to diagnose mental health conditions. As with other conditions, there are specific clinical criteria involving symptoms and course of illness, that need to be met for someone to be diagnosed withschizophrenia.
Positive Symptoms
Symptoms of schizophrenia are referred to as positive or negative. That doesn’t mean that some are good and some are bad.Positive symptomsare those that are present in someone with schizophrenia that someone without schizophrenia or another mental health condition would not experience.Examples of these symptoms include:
Delusions
Delusions are fixed, false beliefs that don’t make sense in the context of a person’s culture. Although everyone has distorted beliefs from time to time, people with psychoticdelusionscan’t be convinced that their beliefs aren’t real.
Hallucinations
Hallucinationsare false sensory experiences that have no basis in the external world. Psychotic hallucinations occur when the person is fully awake and not under the influence of alcohol or drugs.
Auditory hallucinations(hearing voices) and visual hallucinations (seeing things) are the most common, but a person can hallucinate a touch (for example, bugs crawling on the skin), taste, or smell.
Disorganized Speech
Disorganized speech is also known as “loose association.” In psychotically disorganized speech, words are not linked together based on the normal rules of language but may be strung togetherbased on sounds, rhyme, puns, or free associations.
Although everyone makes speech errors, especially when they’re tired or stressed, disorganized speech during aschizophrenic episodeis severely abnormal. It can be difficult or impossible to understand.
Disorganized Behavior
Disorganized behaviors for someone with schizophrenia are not goal-directed and don’t make sense in context. For example, while taking one’s clothes off to take a bath is sensible, taking one’s clothes off on a public bus is an example of disorganized behavior.
Laughing at inappropriate times or for no reason is a disorganized behavior. Adopting strange postures or freezing can be examples ofcatatonic behaviors.
Negative Symptoms
In addition to the positive symptoms that become present in someone with schizophrenia, others are referred to asnegative symptoms. This means that the person is experiencing anabsence or reduction ofcertain traits typically present in healthier individuals.
The term negative suggests that something feels as if it is being taken away or disappearing from the person’s daily experience. Examples of negative symptoms can include things like:
Flattened Affect
People withflattened affectappear emotionless or have a very limited range of emotions. They show little response to emotional or disturbing situations or images. This restricted expression of emotion can be alarming to others, as it can feel like the person with schizophrenia is disappearing from them.
Anhedonia
Reduced Speech
A negative symptom of schizophrenia can involve someone speaking noticeably less than they used to. This particular symptom could also be observed as someone speaking less fluently than before.
Lack of Initiative
The loss of will to do things is a negative symptom of schizophrenia. Remember that a negative symptom refers to a characteristic that seems to be lessening or disappearing from the person. Loss of motivation and initiative, also known asavolition, is a common negative symptom.
Positive SymptomsDelusionsHallucinationsDisorganized speechDisorganized behaviorNegative SymptomsFlattened affectAnhedoniaReduced speechLack of initiative
Positive SymptomsDelusionsHallucinationsDisorganized speechDisorganized behavior
Disorganized speech
Disorganized behavior
Negative SymptomsFlattened affectAnhedoniaReduced speechLack of initiative
Flattened affect
Reduced speech
Lack of initiative
Other Symptoms of Schizophrenia
In addition to the formal diagnostic criteria, there are a variety of other symptoms or comorbidities that can often be found in people with schizophrenia.These symptoms include things like:
Myths About Schizophrenia SymptomsOne common misconception is that violence or aggression are common symptoms of the condition. It is important to recognize that this is not the case. Having schizophrenia does not mean that a person is violent or dangerous. While the condition is chronic, it can be managed effectively with medications, therapy, and support.
Myths About Schizophrenia Symptoms
One common misconception is that violence or aggression are common symptoms of the condition. It is important to recognize that this is not the case. Having schizophrenia does not mean that a person is violent or dangerous. While the condition is chronic, it can be managed effectively with medications, therapy, and support.
More About Cognitive Symptoms
Cognitive symptoms of schizophrenia have to do with the way a person thinks.Although cognitive symptoms are not used to diagnose schizophrenia, some are pretty common with the condition, such as:
When schizophrenia appears before the age of 18, it is referred to as early-onset schizophrenia.Childhood-onset schizophrenia, which occurs before age 13, is also possible, but it is considered very rare.
The earliest signs that may appear in childhood or adolescence include strange thoughts, problems differentiating between reality and imagination, difficulty concentrating, extreme moodiness, social withdrawal, and odd behaviors.
Symptoms in children are the same as in adults, but kids are more likely to have auditory hallucinations.Thought disordersand delusions do not emerge until adolescence or young adulthood.
Because of the variety of symptoms that can be present, schizophrenia can be difficult to diagnose. In an effort to achieve greater precision in the process of diagnosing, the clinical criteria for schizophrenia within the DSM-5-TR have become more complex over time. There are reasons why it is important to diagnose schizophrenia accurately:
DSM-5-TR Criteria
As outlined within the DSM-5-TR, the clinical features that must be present for the condition of schizophrenia to be diagnosed include the following:
Presence of at least two of the following symptom types (with at least one of the symptoms being in the top three listed here):
The symptoms are to be experienced for at least six months, with the psychotic features (the top three listed above) being present for at least one month.
The person experiences significant problems with work and social functioning as a result of their symptoms.
Other Diagnostic Considerations
In addition to exploring and identifying whether or not someone meets the formal clinical criteria as listed in the DSM-5, there are additional things that a mental health provider will consider in the diagnostic process.These include:
Comprehensive exams are an important aspect of diagnosing schizophrenia. A clinician will not rely on limited pieces of information or only on self-reports from the client. They will be gathering information about the client’s family history, substance use and medications, sleep disturbances, appetite changes, and more.
In addition, a clinician needs to explore information related to the person’s values system, perspectives on the world, interests and talents, beliefs, and relationship dynamics. Family and close friends may also be interviewed to help provide helpful collateral information.
Schizophrenia is a complex diagnosis with a lot of symptoms and variables to consider. What makes things more complicated is that there are also several closely related conditions that involve psychosis. Some of the conditions that are to be ruled out can include:
Because of the complexity and variety of symptoms associated with schizophrenia, it can be difficult for people to know if what their loved one is experiencing is concern enough to see a doctor.
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Onset and Duration of Symptoms
The onset of symptoms tends to be gradual, building in severity over time.This sometimes slow progression of symptoms can also make it difficult to know if what you, or someone you love, is experiencing is to be of concern.
Some of the most commonearly warning signsof schizophrenia include anxiety, depression, difficulty thinking clearly, reduced energy, restlessness, and social withdrawal. People may experience such symptoms for years before the condition becomes apparent.
Schizophrenia is a chronic, lifelong condition without a known cure at this time. The symptoms can worsen over time, or they can improve if the condition is well-managed with medication and therapy.Symptoms don’t alwaysget better with age.
What is High Functioning Schizophrenia?
Functioning in Social and Professional Situations
When social and work (or school) functioning is impaired, it may be helpful to consult with a doctor.Because the symptoms tend to develop over time, it can be hard to realize that someone is experiencing difficulty in these areas. Noticing that a pattern has developed can be a signal to consult with a professional.
Challenges in Reaching Out
It can be challenging for people with schizophrenia to reach out to a doctor or other health professional about their concerns. This can be particularly tough for people experiencing symptoms that leave them feeling suspicious of others.
Reassurance from people they trust can help encourage and prompt someone to speak with a doctor or other mental health professional.
What Are the Causes of Schizophrenia?
10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tandon R.Schizophrenia and other psychotic disorders in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5: Clinical implications of revisions from DSM-IV.Indian J Psychol Med.2014;36(3):223-225. doi:10.4103/0253-7176.135365Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T.2014;39(9):638-645.Boutros NN, Mucci A, Diwadkar V, Tandon R.Negative symptoms in schizophrenia. Clin Schizophr Relat Psychoses. 2014;8(1):28-35B. doi:10.3371/CSRP.BOMU.012513Picchioni MM, Murray RM.Schizophrenia.BMJ. 2007;335(7610):91-95. doi:10.1136/bmj.39227.616447.BETargum SD, Keefe RS.Cognition and schizophrenia: Is there a role for cognitive assessments in diagnosis and treatment?Psychiatry (Edgmont). 2008;5(12):55-59.Gochman P, Miller R, Rapoport JL.Childhood-onset schizophrenia: The challenge of diagnosis.Curr Psychiatry Rep. 2011;13(5):321–322. doi:10.1007/s11920-011-0212-4Bartlett J.Childhood-onset schizophrenia: What do we really know?.Health Psychol Behav Med. 2014;2(1):735–747. doi:10.1080/21642850.2014.927738American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Häfner H, Maurer K.Early detection of schizophrenia: Current evidence and future perspectives.World Psychiatry. 2006;5(3):130-138.Greene M, Yan T, Chang E, Hartry A, Touya M, Broder MS.Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder.J Med Econ. 2018;21(2):127-134. doi:10.1080/13696998.2017.1379412Additional ReadingNational Institutes of Mental Health.Schizophrenia.Torrey EF.Surviving Schizophrenia: A Family Manual, 6th Edition.HarperCollins Publishers; 2013
10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tandon R.Schizophrenia and other psychotic disorders in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5: Clinical implications of revisions from DSM-IV.Indian J Psychol Med.2014;36(3):223-225. doi:10.4103/0253-7176.135365Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T.2014;39(9):638-645.Boutros NN, Mucci A, Diwadkar V, Tandon R.Negative symptoms in schizophrenia. Clin Schizophr Relat Psychoses. 2014;8(1):28-35B. doi:10.3371/CSRP.BOMU.012513Picchioni MM, Murray RM.Schizophrenia.BMJ. 2007;335(7610):91-95. doi:10.1136/bmj.39227.616447.BETargum SD, Keefe RS.Cognition and schizophrenia: Is there a role for cognitive assessments in diagnosis and treatment?Psychiatry (Edgmont). 2008;5(12):55-59.Gochman P, Miller R, Rapoport JL.Childhood-onset schizophrenia: The challenge of diagnosis.Curr Psychiatry Rep. 2011;13(5):321–322. doi:10.1007/s11920-011-0212-4Bartlett J.Childhood-onset schizophrenia: What do we really know?.Health Psychol Behav Med. 2014;2(1):735–747. doi:10.1080/21642850.2014.927738American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Häfner H, Maurer K.Early detection of schizophrenia: Current evidence and future perspectives.World Psychiatry. 2006;5(3):130-138.Greene M, Yan T, Chang E, Hartry A, Touya M, Broder MS.Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder.J Med Econ. 2018;21(2):127-134. doi:10.1080/13696998.2017.1379412Additional ReadingNational Institutes of Mental Health.Schizophrenia.Torrey EF.Surviving Schizophrenia: A Family Manual, 6th Edition.HarperCollins Publishers; 2013
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tandon R.Schizophrenia and other psychotic disorders in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5: Clinical implications of revisions from DSM-IV.Indian J Psychol Med.2014;36(3):223-225. doi:10.4103/0253-7176.135365Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T.2014;39(9):638-645.Boutros NN, Mucci A, Diwadkar V, Tandon R.Negative symptoms in schizophrenia. Clin Schizophr Relat Psychoses. 2014;8(1):28-35B. doi:10.3371/CSRP.BOMU.012513Picchioni MM, Murray RM.Schizophrenia.BMJ. 2007;335(7610):91-95. doi:10.1136/bmj.39227.616447.BETargum SD, Keefe RS.Cognition and schizophrenia: Is there a role for cognitive assessments in diagnosis and treatment?Psychiatry (Edgmont). 2008;5(12):55-59.Gochman P, Miller R, Rapoport JL.Childhood-onset schizophrenia: The challenge of diagnosis.Curr Psychiatry Rep. 2011;13(5):321–322. doi:10.1007/s11920-011-0212-4Bartlett J.Childhood-onset schizophrenia: What do we really know?.Health Psychol Behav Med. 2014;2(1):735–747. doi:10.1080/21642850.2014.927738American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Häfner H, Maurer K.Early detection of schizophrenia: Current evidence and future perspectives.World Psychiatry. 2006;5(3):130-138.Greene M, Yan T, Chang E, Hartry A, Touya M, Broder MS.Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder.J Med Econ. 2018;21(2):127-134. doi:10.1080/13696998.2017.1379412
Tandon R.Schizophrenia and other psychotic disorders in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5: Clinical implications of revisions from DSM-IV.Indian J Psychol Med.2014;36(3):223-225. doi:10.4103/0253-7176.135365
Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T.2014;39(9):638-645.
Boutros NN, Mucci A, Diwadkar V, Tandon R.Negative symptoms in schizophrenia. Clin Schizophr Relat Psychoses. 2014;8(1):28-35B. doi:10.3371/CSRP.BOMU.012513
Picchioni MM, Murray RM.Schizophrenia.BMJ. 2007;335(7610):91-95. doi:10.1136/bmj.39227.616447.BE
Targum SD, Keefe RS.Cognition and schizophrenia: Is there a role for cognitive assessments in diagnosis and treatment?Psychiatry (Edgmont). 2008;5(12):55-59.
Gochman P, Miller R, Rapoport JL.Childhood-onset schizophrenia: The challenge of diagnosis.Curr Psychiatry Rep. 2011;13(5):321–322. doi:10.1007/s11920-011-0212-4
Bartlett J.Childhood-onset schizophrenia: What do we really know?.Health Psychol Behav Med. 2014;2(1):735–747. doi:10.1080/21642850.2014.927738
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787
Häfner H, Maurer K.Early detection of schizophrenia: Current evidence and future perspectives.World Psychiatry. 2006;5(3):130-138.
Greene M, Yan T, Chang E, Hartry A, Touya M, Broder MS.Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder.J Med Econ. 2018;21(2):127-134. doi:10.1080/13696998.2017.1379412
National Institutes of Mental Health.Schizophrenia.Torrey EF.Surviving Schizophrenia: A Family Manual, 6th Edition.HarperCollins Publishers; 2013
National Institutes of Mental Health.Schizophrenia.
Torrey EF.Surviving Schizophrenia: A Family Manual, 6th Edition.HarperCollins Publishers; 2013
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