Schizophrenia is a chronic and severe mental illness with a range of symptoms that can impact both the individual and their loved ones long-term. Schizophrenia treatment usually focuses on trying to manage symptoms, rather than working toward eliminating the disorder.
Schizophrenia is persistent, but it is also well-studied and understood by experts. The diagnosis has existed for decades, so researchers and treatment providers have better options for treating the condition now than at any point before.
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Prevalence of Schizophrenia
Finding the true prevalence of schizophrenia is challenging because the condition is complicated with numerous symptoms overlapping other mental health issues. Schizophrenia shares traits with other mental health disorders including:
- Substance use disorders and people who are under the influence of some substances
- Personality disorders including antisocial personality disorder and borderline personality disorder
The National Alliance on Mental Health (NAMI) reports the rate to be slightly higher at 1 percent. Regardless of the estimates, more than 1 million people are affected by the condition directly, with millions more having schizophrenia indirectly impact their lives.
Age of Onset
Compared to other mental health conditions, schizophrenia has a narrow range of onset.
For men, the symptoms of schizophrenia usually begin in a small window of time between their late teens and early twenties. Women commonly experience symptoms slightly later with symptoms emerging anywhere between the late twenties and early thirties.
Someone showing the signs and symptoms of schizophrenia for the first time before age 12 or after age 40 is very rare. Of course, the symptoms may happen at any time, but the average age of onset for schizophrenia is from the late teens and early thirties for men and women.
Course of Illness
Early in the course of schizophrenia, people may isolate themselves by withdrawing from friends, becoming more suspicious of others and displaying an increase in bizarre thinking.
Each person’s experience with schizophrenia will share common themes with others who have the same condition, but so many aspects of the disorder and its path are unique. Experts separate the symptoms of schizophrenia into three main categories:
- Positive symptoms
- Negative symptoms
- Cognitive symptoms
Positive symptoms are the introduction of psychotic symptoms, which represents a break from reality.
Positive symptoms of schizophrenia include:
- Hallucinations – sensory errors where a person thinks they hear, see, smell, taste or feel things that are not present
- Delusions – strong beliefs about people or things which are unrealistic or not supported by facts
- Thought problems – different from delusions, thought disorders involve a person being very disorganized, stopping their train of thought or making up new words
- Movement issues – repeating specific movement or not moving at all for long periods
The negative symptoms of schizophrenia include losing some feelings and interest the person previously had.
Negative symptoms of schizophrenia include:
- Feeling “flat” (i.e., experiencing reduced reactions and range of emotions)
- Feeling less pleasure and happiness in life
- Problems completing expected behaviors
- Speaking less often
Cognitive symptoms of schizophrenia include:
- Diminished ability to think, understand issues and make choices
- Decreased ability to focus and pay attention
When symptoms begin, the individual may change their friends, start underperforming at work or school, show mood changes, or shift their sleeping patterns. At first, a loved one could think the person with schizophrenia is depressed and ignore the problems or seek ineffective treatments.
Schizophrenia is a long-term condition, so when the diagnosis is present, the condition influences thoughts, feelings and behaviors long-term.
Schizophrenia can adversely impact a person’s social and occupational functioning. The condition makes it challenging for the individual to work, finish school and have meaningful relationships. People, men especially, with schizophrenia often have few close connections outside of their family members. Without many relationships, people could feel like they’re missing out on life experiences and lack a sense of belonging.
Though schizophrenia carries a heavy burden, not everyone with the condition is the same. Some people with schizophrenia thrive with careers and have families.
There is no clear indicator regarding who will and will not have a good prognosis with schizophrenia but treatment consistency is a common theme for those who respond well.
Schizophrenia and Co-Occurring Disorders
Many co-occurring mental health and physical health issues link to schizophrenia. People with schizophrenia are more likely to:
- Have an anxiety disorder
- 23 percent of people with schizophrenia have obsessive-compulsive disorder
- 15 percent of people with schizophrenia have panic disorder
- 29 percent have post-traumatic stress disorder
- Suffer from depression with between 30 and 54 percent of people with schizophrenia having depressive symptoms as well
- Experience substance use disorders. Many people use marijuana or alcohol to cope with the disorder, and about 50 percent of all people with schizophrenia will also smoke cigarettes regularly.
A person with schizophrenia may also have symptoms of personality disorders like paranoid or schizotypal personality disorder. There is also a separate condition called schizoaffective disorder that blends aspects of schizophrenia with mood symptoms common in depression and bipolar disorder. Schizoaffective disorders could be a better diagnostic fit for some people.
These mental health conditions can contribute to a high-stress lifestyle, but the physical health consequences of schizophrenia are more dangerous.
The physical health risks of schizophrenia include:
- Heart problems
- Breathing issues
People with schizophrenia are also less likely to attend doctor’s appointments, exercise and maintain a healthy diet. Overall, schizophrenia triggers a shorter lifespan than those without the condition.
Schizophrenia Suicide Risk
The physical health problems associated with schizophrenia contribute to a shorter life expectancy, but suicide plays a significant role as well. People with schizophrenia are more likely than the average person to think about suicide, attempt suicide and complete suicide.
Approximately 5 or 6 percent of people with schizophrenia die by suicide, and about 20 percent of people with schizophrenia attempt suicide at least once. Countless more consider suicide. These rates are much higher than the overall population and are higher than many other mental health conditions.
Young males have the highest risk of suicide, especially if they are abusing alcohol and other drugs. Some will experience hallucinations and delusions that seem to encourage suicide and self-harm.
The risk factors for suicide include:
- High depression
- Not following treatment recommendations
- Feeling hopeless
- Not having a job
- Being recently released from the hospital
People who take their medications as prescribed carry a lower risk of suicide, so encouraging treatment compliance is always a valuable aspect of care.
Schizophrenia and Crime
Any person is capable of being violent or committing a crime, but the majority of people with schizophrenia are not violent and never commit crimes. Due to the increased risk of suicide, people with schizophrenia are much more likely to harm themselves than anyone else.
However, abusing substances can spark feelings of anger that lead to aggression, violence and criminal activity. The highest risk for violence occurs during a period of untreated psychosis. Someone with intense hallucinations or delusions may experience confusion and aggression. Luckily, when in treatment, the risk of violence and crime diminish.
While some people with schizophrenia are in jail, their crimes are mostly misdemeanors and not violent crimes. As many as 20% of people in jail have significant mental health issues. Many people with a severe mental illness transition from jails to hospitals to homelessness.
The Cost of Schizophrenia
All mental health and physical health conditions carry a financial toll. As one of the top causes of disability throughout the world, schizophrenia carries a high cost.
Even compared to other chronic medical and mental illnesses, schizophrenia is a very costly condition. The direct costs include the counseling and medications needed to treat the disease, and the indirect costs include lost productivity at workplaces, financial assistance and other social services. In total, the direct and indirect costs of schizophrenia reach almost $63 million annually.
Though the cost is high, these people deserve compassion and understanding to achieve the best possible quality of life.
Schizophrenia Mortality Rate
As mentioned, schizophrenia dramatically shortens the life of people with the condition. People with schizophrenia have concerns regarding their physical health, mental health, social and economic life, all contributing to lower life expectancy and a higher mortality rate.
Not only do people with schizophrenia have higher rates of substance use disorders, heart disease, liver disease and diabetes, but these conditions are also under-diagnosed and under-treated. Since people with schizophrenia may not go to doctors and follow-up appointments, these diseases do not receive the proper attention and cause more damage.
The amount of life lost to schizophrenia is staggering. The National Institute of Mental Health estimates that someone with schizophrenia is likely to live 28.5 fewer years than someone without schizophrenia.
Statistics on Schizophrenia Recovery
With early intervention, consistent treatment and community support, schizophrenia recovery can be a reality. The common perception of schizophrenia may appear bleak, so it is important to keep a level of optimism and an open mind. Schizophrenia treatments can work.
A small number of people with the condition will go on to make a full recovery with very minimal symptoms. About 20 percent of people with schizophrenia will find treatment to effectively manage their daily symptoms, which allows them to function well in society.
Sadly, that leaves about 80 percent of people with schizophrenia to:
- Remain chronically ill
- Require supports for daily living
- Experience periods of worsening and improving symptoms
- Continually decline while their symptoms progress
To this point, no one can predict who will fit into the 20 percent and who will fit into the 80 percent. The balance of biological, social and environmental risk factors is not well-understood yet in terms of schizophrenia disorders.
The most effective schizophrenia treatments are multifaceted and account for the needs of the entire person, not only their diagnosis. Helpful treatments include:
- Talk therapy
- Social skill training
- Illness management training to see the warning signs and symptoms
- Work and educational rehabilitation
- Family education and supports
- Self-help and support groups
Recovery from schizophrenia is always possible, but it can be challenging. If you or your loved one live with schizophrenia co-occurring with a substance use disorder, consider learning more about available treatment options. Contact The Recovery Village to find out which treatment options will work best for you.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013.
National Alliance on Mental Health. “Schizophrenia.” (n.d.). Accessed on February 16, 2019.
National Institute of Mental Health. “Schizophrenia.” (n.d.) Accessed on February 16, 2019.
National Institute of Mental Health. “Schizophrenia.” May 2018. Accessed on February 16, 2019.
Schizophrenia.com. “Schizophrenia Facts and Statistics.” (n.d.) Accessed on February 25, 2019.
U.S. National Library of Medicine. “Psychiatric Comorbidities and Schizophrenia.” November 14, 2008. Accessed on February 25, 2019.
Hurley, Katie. “Schizophrenia: DSM-5 Definition.” Psycom, February 13, 2018. Accessed March 13, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.