The first episode of schizophrenia typically occurs in the late teenage years or the early 20s. However, the illness can remain undetected for about 2-3 years after the onset of clearly diagnosable symptoms.
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.
Research suggests schizophrenia may be caused by a change in the level of 2 neurotransmitters: dopamine and serotonin. Some studies indicate an imbalance between the 2 may be the basis of the problem. Others have found a change in the body's sensitivity to the neurotransmitters is part of the cause of schizophrenia.
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.
Schizophrenia usually involves delusions (false beliefs), hallucinations (seeing or hearing things that don't exist), unusual physical behavior, and disorganized thinking and speech. It is common for people with schizophrenia to have paranoid thoughts or hear voices.
Early warning signs of schizophrenia
In this early phase of schizophrenia, you may seem eccentric, unmotivated, emotionless, and reclusive to others. You may start to isolate yourself, begin neglecting your appearance, say peculiar things, and show a general indifference to life.
A schizophrenic episode can last days or weeks, and in rare cases, months, says Dr. D'Souza. Some people may experience only one or two schizophrenic episodes in their lifetime, whereas for others the episodes may come and go in phases.
These initial negative symptoms are often referred to as the prodromal period of schizophrenia. Symptoms during the prodromal period usually appear gradually and slowly get worse. They include the person becoming more socially withdrawn and increasingly not caring about their appearance and personal hygiene.
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.
Childhood-onset schizophrenia (COS), characterized by onset before age 13 years, has a prevalence of approximately 1 in 40,000. This is a severe form of the illness with gradual onset and poor outcome.
Schizophrenia usually develops slowly, with early warning signs developing before the first severe episode (psychosis). That is when what are known as positive symptoms—those not generally seen in healthy people, such as hallucinations and delusions—are experienced for the first time.
Trauma. Events such as a death, sexual assault, or war can trigger an episode. But other life events such as pregnancy and childbirth, accidents, loss of a job, or trouble with the law can also put you at risk for one. Substance use.
While no cure exists for schizophrenia, it is treatable and manageable with medication and behavioral therapy, especially if diagnosed early and treated continuously.
Though schizophrenia can vary from one individual to the next, some of the most commonly occurring symptoms include delusions, hallucinations, and a lack of emotion in speech and in facial expressions.
Borderline schizophrenia is held to be a valid entity that should be included in the DSM-III. It is a chronic illness that may be associated with many other symptoms but is best characterized by perceptual-cognitive abnormalities. It has a familial distribution and a genetic relationship with schizophrenia.
Auditory hallucinations, “hearing voices,” are the most common in schizophrenia and related disorders. Disorganized thinking and speech refer to thoughts and speech that are jumbled and/or do not make sense.
If you, or someone you know, are described as having “borderline schizophrenia”, it could point toward mild symptoms, unclear symptoms, or a combination of symptoms. The best thing you can do is to seek clarification from a licensed professional.
Before an episode of psychosis begins, you will likely experience early warning signs. Warning signs can include depression, anxiety, feeling "different" or feeling like your thoughts have sped up or slowed down.
It is possible for anxiety to lead to psychosis symptoms when a person's anxiety is particularly severe. However, such an instance of psychosis is different from an actual psychotic disorder in the cause and treatment approaches.
Psychosis can come on suddenly or can develop very gradually. The symptoms of psychosis are often categorized as either “positive” or “negative.”
Past studies have reported that offspring of affected mothers have a higher risk of schizophrenia than the offspring of affected fathers; however, other studies found no such maternal effect [Gottesman and Shields, 1976].
“If someone with schizophrenia has had good treatment and it's well-controlled, they might seem a little 'off' at times, but you might not even know they have it,” Weinstein says. But for those without access to the medicines and care that they need, or those who stop their treatment, schizophrenia is devastating.
The risk for schizophrenia has been found to be somewhat higher in men than in women, with the incidence risk ratio being 1.3–1.4. Schizophrenia tends to develop later in women, but there do not appear to be any differences between men and women in the earliest symptoms and signs during the prodromal phase.