Schizophrenia
Schizophrenia is a chronic psychotic disorder involving disruptions in thought, perception, and behavior, managed per the 2020 APA Practice Guideline for the Treatment of Patients With Schizophrenia.
Symptoms
Positive symptoms (hallucinations, delusions, disorganized speech), negative symptoms (reduced emotional expression, social withdrawal, low motivation), and cognitive symptoms (difficulty with attention, memory, and executive function).
Causes and risk
A strong genetic contribution combined with prenatal complications, cannabis use, childhood trauma, and social factors; onset is typically in the late teens to early 30s.
How it is evaluated
Diagnosis is clinical, based on DSM-5 criteria; labs and imaging are used to exclude other medical causes of psychosis rather than to confirm the diagnosis itself.
Treatment
Antipsychotic medication is the foundation of treatment, with clozapine reserved for treatment-resistant disease, alongside psychosocial interventions (coordinated specialty care, family psychoeducation, supported employment), per the APA guideline.
When to seek care
New or worsening hallucinations, delusions, suicidal or homicidal thoughts, or an inability to care for oneself all warrant urgent psychiatric evaluation -- call 911 or the 988 Suicide and Crisis Lifeline if there is immediate danger.