Home / Mental health / Schizophrenia
Mental health
Schizophrenia and psychosis
What psychosis and schizophrenia are, how common they are, why early care helps, how recovery is possible, common myths, and links to every topic.
Schizophrenia is a serious mental illness that changes how a person thinks, feels and acts. A person may seem to lose touch with what is real. This can be frightening for them and for the people who love them.1
Schizophrenia is one cause of psychosis (a state where a person has trouble telling what is real).4 It can be treated, and many people go on to live well.5 This page gives the big picture and links to each topic.
Key points
- Psychosis means losing some contact with reality, for example hearing voices or holding false beliefs. Schizophrenia is one illness that can cause it.4
- Schizophrenia affects roughly 1 in 150 to 1 in 400 U.S. adults. Worldwide, about 1 in 300 people live with it.3,6
- It is usually first diagnosed between ages 16 and 30, after a first episode of psychosis.1,2
- Recovery is possible. Care that starts early works best, and at least 1 in 3 people reach complete remission, meaning their symptoms go away.4,6 Strong evidence
- Schizophrenia is not "split personality," and most people with it are not violent.1
- If someone talks about suicide, call or text 988. If life is in danger, call 911.2
What are psychosis and schizophrenia?
Psychosis is a group of symptoms, not one disease. During psychosis, a person's thoughts and senses are disrupted. They may hear voices others do not hear (hallucinations) or hold strong beliefs that are not true (delusions). Speech may be hard to follow.4
Psychosis can have many causes. It can be part of schizophrenia, bipolar disorder or severe depression. It can also come from lack of sleep, some medicines, or alcohol and drug use. In older adults, it can come with Parkinson's disease or dementia.4
Schizophrenia is diagnosed when psychosis and related changes last for a long time and other causes have been ruled out. A doctor looks for at least two core symptoms during a one-month period, plus reduced daily functioning lasting at least six months.5 Learn more on getting diagnosed.
Three groups of symptoms
Doctors group symptoms into three kinds:1,5
- Positive symptoms add things that are not usually there. Examples are hallucinations and delusions. To the person, these feel very real.
- Negative symptoms take away things that are usually there. Examples are flat voice and face, less energy, less interest in people, and trouble starting activities. These are sometimes mistaken for depression.
- Cognitive symptoms affect attention, memory and planning. Problems with thinking are one of the best predictors of how well a person manages day to day.
Read more about signs of schizophrenia and early psychosis.
How common is it?
In the United States, about 0.25% to 0.64% of people have schizophrenia or a related psychotic disorder. That is roughly 1 in 400 to 1 in 156.3 The World Health Organization estimates about 27 million people worldwide, or 1 in 300.6
Psychosis itself is a little more common. Each year, about 15 to 100 of every 100,000 people have a first episode of psychosis.4
It tends to begin in late adolescence to the early twenties for men, and the early twenties to early thirties for women.3 It is rare in young children.1
Early signs and why early care matters
Changes often start slowly, before the first episode of psychosis. Common early signs are:4
- Suspiciousness or odd ideas
- Trouble thinking clearly
- Pulling away from friends and family
- Less care for appearance and hygiene
- Sleep problems
- A sudden drop in school or work performance
Many of these can also be ordinary teen or life stress, so one sign alone does not mean schizophrenia. But if changes grow stronger or do not go away, see a doctor.4
Treatment often starts late. Psychosis symptoms often last for more than a year before a person gets care.4 Getting help sooner leads to better results, and some people who get early treatment never have another episode.4
Myths and facts
Myth
"Schizophrenia means a split personality."
Fact
It does not. Split or multiple personality is a different condition, called dissociative identity disorder. Schizophrenia affects thoughts and perceptions.1
Myth
"People with schizophrenia are dangerous."
Fact
Most are not violent. They are more likely to be harmed by others than to harm anyone. The risk of violence is higher when the illness goes untreated or when drugs or alcohol are involved.1
Myth
"There is nothing that can be done."
How treatment works
There is no cure yet, but treatment can control symptoms and help a person live well. A good plan usually combines several parts.5,7
Never stop or change a medicine on your own. Stopping suddenly can bring symptoms back. Talk with your doctor or pharmacist before changing anything.1
Physical health and life expectancy
People with schizophrenia die about nine years earlier than others on average. The gap is often due to heart, metabolic (such as diabetes) and infectious diseases.6 Regular checkups, healthy eating, movement, and help quitting smoking and alcohol all matter. Find out more in therapy and recovery.
Schizophrenia in later life
Most people with schizophrenia are diagnosed young and grow older with it. They need care for medicine side effects and physical health as they age. In older adults, psychosis can also come with Parkinson's disease or dementia, so doctors check for other causes.4 See psychosis and schizophrenia in later life, and our guide to dementia.
Supporting someone you love
Remember that voices and beliefs feel completely real to the person. Be respectful and kind, and encourage treatment, without accepting unsafe behavior.1 Family education groups, such as those from NAMI, help relatives understand the illness and handle stress.1,5 Take care of yourself too. Read helping a family member with psychosis, when a family member is in a mental health crisis and caregiver burnout.
All schizophrenia and psychosis topics
- Signs of schizophrenia and early psychosis
- Causes and risk factors
- Getting diagnosed and related conditions
- Antipsychotic medicines
- Therapy and recovery
- Helping a family member with psychosis
- Psychosis and schizophrenia in later life
Related: bipolar disorder, which can also include psychosis.
In this section
Signs and symptoms
Learn the signs of schizophrenia and early psychosis: voices, false beliefs, withdrawal, thinking problems, early warning signs and when to get help.
Read →Causes and risk
What raises the risk of schizophrenia: genes, brain development, cannabis, stress, trauma and city life, and what does not cause it, such as parenting.
Read →Getting diagnosed
How doctors diagnose schizophrenia, which checks rule out other causes, and how related conditions such as schizoaffective disorder differ.
Read →Therapy and recovery
How early psychosis programs, talk therapy, family help, job support and peer groups work alongside medicine, and why physical health care matters.
Read →Helping family
How to talk with a loved one during psychosis, what to do when they do not think they are ill, how to plan for a crisis, and how to care for yourself.
Read →Later life
How schizophrenia changes with age, what late-onset psychosis is, how to tell it from dementia and delirium, and why antipsychotic safety matters.
Read →Antipsychotics
How antipsychotic medicines help in schizophrenia, newer options, long-acting shots, clozapine, side effects, checkups, and why not to stop suddenly.
Read →When to get help
See a doctor soon if you or someone you love shows signs of psychosis, such as hearing or seeing things others do not, strong false beliefs, or a big change in thinking and behavior. A primary care doctor is a good first step. They can check for medical causes and refer you to a mental health professional.1 You can also take our mental health check-in.
Get help right away if:
- Someone talks about suicide or wanting to die. Call or text 988, or chat at 988lifeline.org.2
- Someone is in danger or may hurt themselves or others. Call 911.2 Tell the dispatcher it is a mental health emergency and ask for a crisis-trained responder if one is available.
Psychosis can be treated. Asking for help is the right step.
Sources
- National Institute of Mental Health. Schizophrenia (NIMH publication). NIMH. NIMH
- National Institute of Mental Health. Schizophrenia (health topic). NIMH. NIMH
- National Institute of Mental Health. Schizophrenia statistics. NIMH. NIMH
- National Institute of Mental Health. Understanding psychosis. NIMH. NIMH
- National Alliance on Mental Illness. Schizophrenia. NAMI. NAMI
- World Health Organization. Schizophrenia fact sheet. WHO. WHO
- American Psychiatric Association. APA releases new practice guideline on treatment of patients with schizophrenia. APA, 2020. APA
- U.S. Food and Drug Administration. FDA approves drug with new mechanism of action for treatment of schizophrenia. FDA, 2024. FDA
Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.