Global Statistics

All countries
260,823,284
Confirmed
Updated on November 26, 2021 11:05 pm
All countries
233,867,292
Recovered
Updated on November 26, 2021 11:05 pm
All countries
5,205,503
Deaths
Updated on November 26, 2021 11:05 pm

Global Statistics

All countries
260,823,284
Confirmed
Updated on November 26, 2021 11:05 pm
All countries
233,867,292
Recovered
Updated on November 26, 2021 11:05 pm
All countries
5,205,503
Deaths
Updated on November 26, 2021 11:05 pm

Schizophrenia

Practice Essentials

Schizophrenia is a brain disorder that affects how people think, feel, and perceive. The hallmark symptom of schizophrenia is psychosis, such as experiencing auditory hallucinations (voices) and delusions (fixed false beliefs).

Signs and symptoms

The symptoms of schizophrenia may be divided into the following 4 domains:

Positive symptoms – Psychotic symptoms, such as hallucinations, which are usually auditory; delusions; and disorganized speech and behavior

Negative symptoms – Decrease in emotional range, poverty of speech, and loss of interests and drive; the person with schizophrenia has tremendous inertia

Cognitive symptoms – Neurocognitive deficits (eg, deficits in working memory and attention and in executive functions, such as the ability to organize and abstract); patients also find it difficult to understand nuances and subtleties of interpersonal cues and relationships

Mood symptoms – Patients often seem cheerful or sad in a way that is difficult to understand; they often are depressed

See Clinical Presentation for more detail.

Diagnosis

Schizophrenia is not associated with any characteristic laboratory results.

Diagnostic criteria

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5), to meet the criteria for diagnosis of schizophrenia, the patient must have experienced at least 2 of the following symptoms
:

Delusions

Hallucinations

Disorganized speech

Disorganized or catatonic behavior

Negative symptoms

At least 1 of the symptoms must be the presence of delusions, hallucinations, or disorganized speech.

Continuous signs of the disturbance must persist for at least 6 months, during which the patient must experience at least 1 month of active symptoms (or less if successfully treated), with social or occupational deterioration problems occurring over a significant amount of time. These problems must not be attributable to another condition.

The American Psychiatric Association (APA) removed schizophrenia subtypes from the DSM-5 because they did not appear to be helpful for providing better-targeted treatment or predicting treatment response.

See Workup for more detail.

Management

Antipsychotic medications diminish the positive symptoms of schizophrenia and prevent relapses.

There is no clear antipsychotic drug of choice for schizophrenia. Clozapine is the most effective medication but is not recommended as first-line therapy.

Psychosocial treatment is essential. The best-studied psychosocial treatments are social skills training, cognitive-behavioral therapy, cognitive remediation, and social cognition training.

Psychosocial treatments are currently oriented according to the recovery model. According to this model, the goals of treatment for a person with schizophrenia are as follows:

To have few or stable symptoms

Not to be hospitalized

To manage his or her own funds and medications

To be either working or in school at least half-time

See Treatment and Medication for more detail.

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