Schizophrenia is a serious mental illness that can interfere with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is frequently a complex, long-term medical illness. The exact prevalence of schizophrenia is difficult to measure. However, previous estimates for schizophrenia and related psychosis disorders ranged from 0.25% to 0.64% of U.S. adults, with a newer estimate for schizophrenia spectrum conditions at 1.2% of U.S. adults. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It’s important to be aware that with early diagnosis and treatment, it is possible to live well with schizophrenia.
Research suggests that schizophrenia may have a combination of possible causes, some of which include:
People with schizophrenia may have additional illnesses. These may include:
Successfully treating schizophrenia often improves these related illnesses. And successful treatment of substance misuse, PTSD or OCD usually improves the symptoms of schizophrenia. These co-occurring diagnoses require a more tailored treatment plan so be sure to ask your health care provider about how multiple conditions can be addressed.
Reviewed and updated December 2025
Symptoms of schizophrenia often begin during the teenage and young adult years, when it can be especially difficult to diagnose schizophrenia. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability — common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the “prodromal” period.
It’s important to be aware that symptoms of schizophrenia can occur at any age, and regardless of age, it’s essential to get a comprehensive medical evaluation to obtain the most accurate diagnosis. It’s also important to know that an accurate diagnosis often takes time. It’s not uncommon for people to receive a different diagnosis initially until the health care professional learns more about what a person is actually experiencing. This can be frustrating for the person and their family.
Schizophrenia symptoms typically fall into three major categories: positive symptoms, negative symptoms, and cognitive issues/disordered thinking. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning (difficulty with daily tasks, relationships, and school/work life) for at least 6 months:
NAMI has partnered with the Foundation of the National Institute of Health and many other public and private entities to create the Accelerated Medicines Partnership for Schizophrenia (AMP-SCZ). This collaborative international research effort seeks to biologically identify at risk individuals who are developing psychosis to help create biomarkers to improve diagnosis and early intervention.
Reviewed and updated December 2025
Schizophrenia is a complex illness and can be difficult to diagnose. One of the things that can make diagnosis difficult is that there are other conditions that can sometimes cause a person to have schizophrenia-like symptoms, even if they don’t actually have schizophrenia. Conditions like brain tumors, thyroid problems, drug use and other medical conditions must be ruled out by a health care professional before an accurate diagnosis of schizophrenia can be made. The difficulty of diagnosing schizophrenia is also complicated by the fact that many people who are diagnosed do not believe that anything is wrong with them, or that they even are experiencing the condition. An accurate diagnosis is essential to ensure that people receive the most effective treatment and support, and waiting to get this diagnosis can be frustrating for the person and their family.
Without a single physical or lab test (like a blood pressure reading, glucose test or x-ray) that can diagnosis schizophrenia, it is necessary to rely on a health care professional to rule out other medical conditions – including other mental illnesses – and evaluate the symptoms and the course of a person’s illness over 6 months to help obtain the most accurate diagnosis.
To be diagnosed with schizophrenia, a person must have 2 or more of the following symptoms, each present for a significant portion of time during a 1-month period, with signs of reduced functioning (difficulty with daily tasks, relationships, and school/work life) persisting for at least 6 months:
Note: Cognitive difficulties — such as problems with attention, working memory, or decision-making — are also common in schizophrenia, but they are not among the core diagnostic criteria. These symptoms can nonetheless have a major impact on daily functioning and quality of life.
Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. Identifying symptoms as early as possible greatly improves a person’s ability to manage the illness, reduce psychotic episodes, and live in recovery. People who receive appropriate care including a combination of medication and psychotherapy during their first psychotic episode typically have fewer subsequent hospital admissions and may require less time to control symptoms than those who don’t receive immediate help. Psychotherapy, family support, and other psychosocial services help people strengthen coping skills, work toward recovery and build insight.
Remember, getting a correct diagnosis takes time. The “movie” of a person’s life is more likely to yield a correct diagnosis than a “snapshot” or single interview. Regularly working with a team of people you trust increases your chances both of getting the right diagnosis and of a treatment plan tailored to your individual needs.
Research shows that Black and Latino individuals are more likely to be misdiagnosed with schizoaffective or other psychotic disorders. Factors such as provider bias and limited access to culturally responsive care can all contribute to this disparity. Working with a mental health professional who understands your cultural background and values can help ensure an accurate diagnosis and effective treatment.
Reviewed and updated December 2025
Early or first-episode psychosis (FEP) refers to when a person first shows signs of losing contact with reality. Acting quickly to connect a person with the right treatment during early psychosis or FEP can be life-changing and radically alter that person’s future. Don’t wait to take the first step and prepare yourself with information by reviewing these tip sheets:
Effective treatment for schizophrenia is comprehensive and integrates medication, psychotherapy, psychosocial support, and physical health management. Collaboration among psychiatrists, therapists, peer specialists, and primary care providers with the person and their family is key to recovery. Getting treatment as early as possible after symptoms begin can make a big difference in symptom severity and recovery. It is important to work with a health care professional to develop a treatment plan that works best for you.
Coordinated Specialty Care (CSC) is a successful model that combines all the best treatments for people in the first years of psychosis and has been shown to improve outcomes. CSC is available in almost 400 programs at the time of this update. If there is an opportunity to get early support and care, see if one of these innovative programs is right for you or your family member. Learn more and find your closest treatment facility using the resources below:
There is no cure for schizophrenia, but it can be treated and managed in several ways, often in combination:
Recovery while living with schizophrenia is often seen over time, and involves a variety of factors including self-learning, peer support, school and work, and finding the right supports and treatment.
Medication is an essential part of treating schizophrenia. Antipsychotic medications help reduce symptoms such as delusions, hallucinations, and disorganized thinking. Working closely with a health care professional to find the right medication and dose can make a significant difference in recovery. Because medications can cause side effects, it’s important to have regular check-ins with your health care professional to monitor how you’re feeling and make adjustments as needed.
Antipsychotic medications fall into two main groups:
For people who prefer not to take daily oral medications, long-acting injectable (LAI) formulations, given every few weeks or months, are available and can be a convenient and effective option. LAIs help ensure consistent medication levels in the body and can lower the risk of relapse.
It’s important to specifically mention one medication — clozapine (Clozaril) — a unique second-generation antipsychotic. It is mentioned specifically because it is the only FDA-approved medication for treatment-resistant schizophrenia (TRS). It is also the only FDA-approved medication to reduce suicidality in people living with schizophrenia. Clozapine has additional blood monitoring requirements and side effects, but remains an underutilized resource for people who have not responded to treatment with at least 2 different antipsychotic medications. Clozapine has been shown to be the most effective medication in these cases.
With the help of families and individuals sharing their experiences, NAMI and other advocacy organizations successfully advocated for a reduction in paperwork and process to access clozapine at the FDA in 2025. This announcement signaled the removal of the risk evaluation and mitigation strategy (REMS) process, which eliminates some of the barriers to clozapine use.
Finding the right medication can take time. Some people may need to try more than one medication or dose before finding what works best. Shared decision-making, involving the person, the health care professional and the family, to discuss the benefits, side effects, and personal goals, can help make treatment more effective and sustainable over time.
Psychotherapy can help people better understand their experiences, manage symptoms, and improve quality of life. Therapy is most effective when combined with medication and support from family and community programs.
People who engage in psychosocial therapeutic interventions often see improvement and experience greater mental stability. Psychosocial interventions enable people to compensate for or eliminate the barriers caused by their schizophrenia and learn to live well. They may be more likely to continue taking their medication and less likely to experience a return or worsening of symptoms. Some of the more common psychosocial interventions include:
Complementary and alternative health approaches including acupuncture, meditation, and nutrition interventions can be part of a comprehensive treatment plan. For example, Omega-3 fatty acids, commonly found in fish oil, have shown some promise for treating and managing schizophrenia. Some research suggests that omega-3 fatty acids may have supportive benefits for brain health, but more evidence is needed before recommending them as a primary treatment.
For resources and developments in research, visit the National Center for Complementary and Integrative Health.
Physical Health. Schizophrenia is associated with other health conditions and behaviors, such as diabetes, cardiovascular problems, lung disease, and smoking. It’s important to work with your health care provider to address your mental and physical health. Some antipsychotic medications also add to risk of obesity and diabetes. Coupled with smoking, this poses critical risks to some people. NAMI developed Hearts+Minds to help people reduce their risk of premature cardiac disease.
GLP-1 medications may also be a useful tool to reduce weight gain and other metabolic health risks in people with mental illness, particularly those taking certain antipsychotic medications. Talk with your health care provider to learn more.
Substance Use. People with schizophrenia are at an increased risk for misusing drugs or alcohol. Substance use can make treatments for schizophrenia less effective, make people less likely to follow their treatment plans, and even worsen symptoms.
Reviewed and updated December 2025
Schizophrenia can come with challenges, but there is help. NAMI is here to provide support for you and your family and information about community resources. NAMI offers a variety of information and programs tailored to the specific needs of people experiencing these conditions and their family members. These programs are all led by people with their own personal experience with these conditions which makes the information they are sharing even more powerful. To learn more about these programs visit www.nami.org/programs or contact the NAMI HelpLine at 1-800-950-NAMI (6264) or [email protected] if you have any questions about psychosis or finding support and resources. You can also use the Find Your Local NAMI tool to find a NAMI in your own community.
There are many ways to help manage your symptoms to prevent them from getting worse and reduce the chance of experiencing a mental health crisis:
If you live with a mental health condition, learn more about managing your mental health and finding the support you need.
Learning about psychosis and schizophrenia will help you understand what your friend or family member is experiencing and trying to cope with. Living with schizophrenia can be challenging, so here are some ways you can show support:
Find out more about taking care of your family member or friend and yourself.
Reviewed and updated December 2025
NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “NAMI” to 62640, or email. In a crisis, call or text 988 (24/7).
