The symptoms and functioning in some persons with schizophrenia will worsen over time, and many will remain stable. Some, however, will improve.
Schizophrenia is a chronic disorder that may wax and wane in severity, but it does not typically worsen with age. 1 For some people, the symptoms of schizophrenia will improve over time while for others the symptoms will stay the same or get worse.
Deterioration has been a part of the description and process of schizophrenia since Kraepelin. The underlying nature of these neurodynamic deficit processes remains unknown, but their clinical manifestations demonstrate somewhat predictable patterns of expression and progression.
Although it starts out as a neurodevelopmental disorder, schizophrenia becomes neurodegenerative after onset, with each new psychotic episode leading to further damage, said Dr. Nasrallah, professor of psychiatry, neurology, and neuroscience at the University of Cincinnati.
Schizophrenia treatment includes medication, therapy, social and family support, and the use of social services. Treatment must be ongoing, as this is a chronic illness without a cure. When schizophrenia is treated and managed over the long-term, most people can live normal, productive, and fulfilling lives.
People with schizophrenia generally live about 15 to 20 years less than those without the condition. Schizophrenia is a complex disease. There are many ways it can result in serious complications.
People with schizophrenia often die at a considerably younger age than the rest of the population. Reasons for this include: late diagnosis and poor treatment of physical illnesses, metabolic side effects of antipsychotic medication, unhealthy lifestyle and high risk of suicide (reviewed by Laursen et al, 2014).
In older adults with schizophrenia, extrapyramidal symptoms occur at lower D2 receptor occupancies than in younger patients. Older age is also a risk factor for antipsychotic adverse effects such as parkinsonism, tardive dyskinesia, falls, and metabolic syndrome.
At least one third of people with schizophrenia experiences complete remission of symptoms (1). Some people with schizophrenia experience worsening and remission of symptoms periodically throughout their lives, others a gradual worsening of symptoms over time.
Moderate quality evidence finds the overall rate of remission is around 36% in people with schizophrenia. In people with first-episode psychosis, the rate is around 58% by 5.5 years.
If left untreated, schizophrenia can worsen at any age, especially if you continue to experience episodes and symptoms. Typically, early onset schizophrenia in the late teens tends to be associated more with severe symptoms than later-life onset. But aging can change the trajectory of how symptoms show up.
Clearly, some with schizophrenia fare better without antipsychotic drugs. But not all. Many individuals with schizophrenia are better off taking antipsychotic drugs for long-term. It has been known for a century that some individuals with schizophrenia recover and do not need ongoing treatment.
The peak age of onset of schizophrenia is 15 – 25 years in men and 20 – 30 years in women. It is often preceded by a prodromal phase of vague symptoms, some odd behaviours and a decline in functioning at school or work and interpersonally.
In most people with schizophrenia, symptoms generally start in the mid- to late 20s, though it can start later, up to the mid-30s. Schizophrenia is considered early onset when it starts before the age of 18. Onset of schizophrenia in children younger than age 13 is extremely rare.
Men usually develop schizophrenia symptoms between their late teens and early twenties, whereas symptoms usually appear in women in their late twenties to early thirties. Across all genders, though, schizophrenia symptoms rarely occur before the age of 13 or after the age of 40.
John Nash Jr.
Then paranoia, delusions, and other symptoms of schizophrenia took hold. Nash's descent into mental illness lasted for 20 years. But he slowly improved and returned to teach at Princeton University. In 1994, he won the Nobel Prize in Economics.
People with schizophrenia require lifelong treatment. But the earlier treatment begins, the better their chances for recovery and improved quality of life. Medication and therapy can help manage the symptoms of schizophrenia.
Most people with schizophrenia make a recovery, although many will experience the occasional return of symptoms (relapses). Support and treatment can help you to manage your condition and the impact it has on your life.
Schizophrenia has been described as the “worst disease” to afflict mankind. It causes psychosis, which is an abnormal state of mind marked by hyperarousal, overactivation of brain circuits, and emotional distress. An untreated episode of psychosis can result in structural brain damage due to neurotoxicity.
Personality disorders that are susceptible to worsening with age include paranoid, schizoid, schizotypal, obsessive compulsive, borderline, histrionic, narcissistic, avoidant, and dependent, said Dr. Rosowsky, a geropsychologist in Needham, Mass.
As you get older, the positive symptoms of schizophrenia like delusions and hallucinations will likely improve. Also, as you age, self-medicating through substance abuse is less common. How well you function in terms of mental health may also improve.
“Adults with schizophrenia are about 10 times more likely to die of COPD and 7 times more likely to die of diabetes,” says a co-author of the study, Mark Olfson, MD, a psychiatrist at Columbia University Irving Medical Center in New York City.
Cognitive decline can eventually lead to dementia. A 2018 study suggests that people with schizophrenia have a nearly twofold increased risk of dementia after adjusting for other standard risk factors.
Shrinkage is a normal part of brain development. Previous research has found that during adolescence - the period when schizophrenia tends to set in - most shrinkage occurs in the frontal lobes. These areas of the brain are involved in abstract thinking and have also been identified as being affected in schizophrenia.
Both first-generation and second-generation antipsychotics cause adverse effects that are known to increase the risk of dying from cardiac, respiratory, and endocrine diseases. Psychiatric users of antipsychotics die at high rates from these somatic illnesses.