How Doctors Diagnose Schizophrenia

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Seeing a doctor to find out if you might have schizophrenia can make you feel afraid and confused. But the more you know about how doctors diagnose the disease, the more comfortable you’ll feel with the doctor and the better you’ll be able to cope with the diagnosis process. 

Even though there's no cure for schizophrenia, it’s important to remember that with early diagnosis and treatment, many people live good, meaningful lives. 

Schizophrenia affects about 1% of the population. The exact cause is not known. But it does tend to run in families. You have about a 10% chance of having the condition if a parent or sibling has schizophrenia. 

To figure out if you have schizophrenia, your doctor will probably have you see a psychiatrist. This doctor has special training in mental health issues. However, schizophrenia cannot be diagnosed with just one simple test. A diagnosis requires observing symptoms over a period of about six months. The doctor also has to rule out other possible causes for the symptoms. Other possible causes could include drug use, other mental health issues, or other medical and neurologic conditions. 

Symptoms of Schizophrenia

Symptoms usually start between ages 16 and 30. They rarely start after age 45. People with schizophrenia usually don’t recognize their symptoms as being abnormal. It's often a family member who notices the symptoms first. The earliest signs may be loss of friendships, poor grades at school, or increasing irritability and withdrawal.  Oftentimes it is friends or family members who direct the affected individual to medical attention.

Your doctor will look for other signs and symptoms to diagnose schizophrenia. They are known as the major symptoms of the condition: 

  • Delusions. These are false beliefs. An example is paranoia. That is the false belief that someone is trying to harm you. 

  • Hallucinations. These could include hearing, seeing, smelling or feeling things that are not real. Hearing voices is the most common type of hallucination.

  • Disorganized thoughts and speech. Someone with schizophrenia might lose track of thoughts in the middle of a sentence. Or, the person might make up words.

  • Disorganized behavior. This refers to body movement. It includes repeated and abnormal movement. It also includes catatonia, which is a complete lack of movement or response.

  • Negative symptoms. Loss of emotion and loss of energy are two examples.

  • Impaired functioning. This means people are unable to work, go to school, have relationships, or care for themselves.

Making a Final Diagnosis

Doctors follow set guidelines to determine if someone has schizophrenia. The latest recommendations from mental health experts on how to diagnose this disease say that someone with schizophrenia: 

  • Must have at least two of the major symptoms
  • Must have had symptoms for at least six months
  • Must have had active symptoms for at least one full month
  • Has had other possible causes for psychosis ruled out

Right now, observing symptoms is the only way to diagnose schizophrenia. Research is being done to find other ways. These may include brain scans or blood tests.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 2

  1. Schizophrenia. National Alliance on Mental Illness.

  2. Frequently Asked Questions About Schizophrenia. Brain & Behavior Research Foundation.

  3. Schizophrenia – Diagnosis. NHS Choices.

  4. Schizophrenia. National Institutes of Health. National Institute of Mental Health.

  5. Diagnosing Schizophrenia. Mount Sinai Hospital.

  6. Tandon R, et al. Definition and description of schizophrenia in the DSM-5, Schizophr. Res. 2013;150(1):3-10.

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