Schizophrenia is a mental health diagnosis given for a lasting pattern of psychotic symptoms, meaning hallucinations, fixed beliefs others do not share and muddled thinking, together with a loss of drive, expression and mental sharpness. Around 1 in 100 people experience it, usually starting in early adulthood.
Key points
- Schizophrenia is a lasting pattern of psychotic symptoms, loss of drive and difficulty thinking clearly.
- It is not a split personality, and around 1 in 100 people experience it.
- Most people with schizophrenia are not violent: psychosis accounted for no more than 10% of violence in populations studied.
- Negative and cognitive symptoms shape daily life more than hallucinations, and medicines do less for them.
- Not a fixed decline: around 1 in 5 met clinical recovery criteria after a first episode.
Symptoms
- Positive symptoms: hearing voices, fixed beliefs others do not share, muddled thinking and speech.
- Negative symptoms: loss of motivation and withdrawal, loss of interest in activities, reduced self-care.
- Cognitive symptoms: difficulty with memory, learning, concentration and decision-making.
Causes and risk factors
- Family history: if one identical twin has schizophrenia, the other has around a 1 in 2 chance.
- Pregnancy and birth complications; differences in brain structure and dopamine activity; stress as a trigger in someone already at risk.
- Regular cannabis use in the teenage years is linked to higher risk, with stronger cannabis carrying higher risk, though causation is not fully established.
Treatment
- First episode: oral antipsychotic medication with psychological interventions offered together, through early intervention services.
- Individual CBT for psychosis (at least 16 sessions) and family intervention (at least 10 sessions).
- Clozapine is offered where illness has not responded to at least two different antipsychotics.
- Annual physical health monitoring - weight, blood glucose, lipids, blood pressure - because life expectancy is reduced mainly through physical health causes.
When to speak to a professional
- You or someone close to you has been hearing or seeing things others do not, or losing drive and withdrawing over weeks.
- Ask about early intervention in psychosis services for a first episode.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.