What Is Schizophrenia? Symptoms, Causes, Diagnosis, and Treatment

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Schizophrenia can be difficult to diagnose. That’s partially because people with schizophrenia symptoms may not realize they have it and may not take themselves to a doctor for treatment.

In the past, doctors split schizophrenia patients into five subtypes depending on their dominant symptoms: paranoid, disorganized, catatonic, undifferentiated, and residual.

In 2013, the APA eliminated these schizophrenia subtypes and the APA’s guidelines opted instead for a broader schizophrenia definition because schizophrenia symptoms can change over time, and symptoms may overlap.

Schizophrenia Testing and Diagnosis

No single, definitive test exists for schizophrenia. Thorough clinical interviews are used to diagnose the disease. A doctor will test for — or diagnose — schizophrenia by ruling out other medical conditions that may be causing symptoms.

Other conditions that can be associated with psychotic symptoms include:

  • Bipolar disorder
  • Severe depression

  • Schizoaffective disorder
  • Medication interactions (combining certain drugs that causes hallucinations and other symptoms similar to schizophrenia)
  • Vitamin deficiencies, most notably B12
  • Infectious disease, such as HIV

  • Autoimmune disease, like lupus
  • Hormone-related conditions such as hypo- or hyperthyroidism
  • Neurological disorders, including seizures, strokes, and neurocognitive illness
  • Brain tumors or other cancers
  • Legal or illegal drug use, including marijuana and alcohol
  • Overuse of stimulants — including methamphetamine (meth) and amphetamine and dextroamphetamine (Adderall, used to treat ADHD) — can cause drug-induced psychosis and schizophrenia-like symptoms

The process of testing and diagnosis will include:

Psychological Evaluation A doctor or mental health worker will ask you a range of questions about your thoughts, moods, delusions, hallucinations, and substance use. This evaluation is considered a critical part of the diagnostic assessment.

Medical Tests A health worker may draw your blood for tests that can help rule out other conditions.

These tests will also screen for any alcohol or drugs in your system that may be contributing to your symptoms.

Your doctor may also recommend imaging studies of your head, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI).

A diagnosis of schizophrenia requires that two or more of the following symptoms are persistent for at least six months:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms

First Episode Psychosis

Psychosis is defined as a break with reality. It can involve hearing voices, experiencing hallucinations, or having paranoia and other delusional thoughts.

Research estimates that between 15 and 100 people out of 100,000 develop psychosis each year, according to the National Institute of Mental Health.

Not everyone who experiences a psychotic episode has a mental illness. Sleep deprivation, certain prescription medications, and disordered use of alcohol or drugs can cause psychosis. But it can also be caused by mental illnesses like schizophrenia.

Psychosis can make it difficult for someone to tell what’s real and what isn’t. The changes in thoughts and perceptions can be gradual. People experiencing psychotic symptoms for the first time may not understand what’s happening. They may feel confused or distressed.

In these cases, friends, family members, or others in the community, including police officers, may be the first to spot psychotic behaviors.

It’s best to seek medical treatment immediately if you or someone you know might be experiencing signs of psychosis or schizophrenia. Early diagnosis — and prompt treatment — can greatly increase the chances that medication and other schizophrenia treatments will work effectively.

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