Schizophrenia is characterized by the onset of thoughts and emotions that are so impaired that the person experiencing them seems to have lost touch with reality and is in great distress. Delusions and hallucinations are common in persons with this illness. It is a serious psychiatric disorder and one of the most complex. Persons with schizophrenia often find it difficult to lead a normal life.
According to the National Institute of Mental Health, about 2.4 million Americans have schizophrenia. The disease affects an equal number of men and women equally, although men generally experience symptoms earlier than women. Schizophrenia typically first appears in men during their late teens or early 20s, whereas women usually develop schizophrenia during their 20s or early 30s .
Causes of Schizophrenia
No single cause of schizophrenia has been identified. A chemical imbalance in the brain appears to be necessary for schizophrenia to develop. However, it is likely that many factors — genetic, behavioral and environmental — play a role in the development of schizophrenia. Schizophrenia runs in families; the risk for developing the disease increases with multiple affected family members.

Types of Schizophrenia
There are two subtypes of schizophrenia: 
  • Persons with the paranoid subtype have auditory hallucinations or prominent delusional thoughts about persecution or conspiracy, often with a particular theme. This is the most common type of schizophrenia.
  • Those with the disorganized subtype of schizophrenia have significant disorganization of their thought processes, which impairs their ability to function normally. Impairment of emotion and communication also characterize this type of schizophrenia.

A person may be diagnosed with different subtypes over the course of the illness.

Symptoms of Schizophrenia
Schizophrenia symptoms vary with each individual and only a few symptoms may be present:
  • Distorted perception of reality (difficulty telling dreams from reality)
  • Confused thinking (for example, confusing something seen on television with reality)
  • Detailed and bizarre thoughts and ideas
  • Suspiciousness and/or paranoia (fearfulness that someone, or something, will harm them)
  • Hallucinations (seeing, hearing or feeling things that are not real, such as voices telling them to do something)
  • Delusions (false beliefs that are not part of the person's culture and do not change even after other people prove that the beliefs are not true or logical)
  • Thought disorders (unusual or dysfunctional ways of thinking including "disorganized thinking")
  • Extreme moodiness or inability to manage emotions
  • Severe anxiety and/or fearfulness
  • Disorganized speech (including speech that is incomprehensible)
  • Lack of emotional expression when speaking (flat affect)
  • Difficulty in performing functions at work and/or school
  • Exaggerated self-worth and/or unrealistic sense of superiority
  • Social withdrawal (severe problems in making and keeping friends)
  • Sudden agitation or confusion
  • Catatonic behavior (sitting and staring, as if immobilized)
  • Odd or bizarre behaviors (agitated body movements or repetition of certain motions)

Cognitive symptoms are also common in persons with schizophrenia, but they are subtle and may be difficult to recognize as part of the disorder:
  • Poor executive functioning (ability to understand information and use it to make decisions)
  • Difficulty focusing or paying attention
  • Problems with working memory (ability to use information immediately after learning it)

Diagnosing Schizophrenia
Your doctor will perform a thorough physical exam, obtain a medical and social history and conduct a careful psychiatric evaluation to diagnose schizophrenia. Laboratory or other tests may be needed to rule out any other causes of symptoms such as drug use or other mental illnesses.

Treating Schizophrenia
Early intervention in individuals with schizophrenia can improve quality of life. Treatment is most successful when symptoms of the first psychotic episode are addressed properly and promptly. Specific treatment for schizophrenia will be determined by your particular circumstances and take into account:
  • Your age, overall health and medical history
  • The severity and extent of your disease
  • Your tolerance for specific medications, procedures or therapies
  • Your expectations for the course of the disease
  • Your opinion or preference

Treatment for schizophrenia is complex. Psychiatric specialists will often suggest a combination of therapies to meet the individualized needs of a patient with schizophrenia, including:
  • Medications (neuroleptic and antipsychotic drugs) can help reduce the symptoms of schizophrenia but must be taken consistently to be effective.
  • Individual and family psychotherapy (including cognitive behavioral therapy) can help the affected person and family understand more about schizophrenia and learn to manage its symptoms.
  • Specialized educational and/or structured activity programs (i.e., social skills training, vocational training, speech and language therapy) are needed to help the person with schizophrenia with activities of daily living.
  • Self-help and support groups may play a key role in avoiding relapse and helping patients cope with their disease.