The exact cause isn’t fully understood, but it is believed to be due to a combination of:

• Genetics – Family history can increase risk.

• Brain chemistry – Imbalances in neurotransmitters like dopamine and glutamate.

• Environmental factors – Stress, trauma, prenatal complications, or substance abuse.

Symptoms are usually grouped into three categories:

• Positive symptoms (added behaviors): Hallucinations, delusions, disorganized speech.

• Negative symptoms (loss of abilities): Lack of motivation, reduced emotional expression, social withdrawal.

• Cognitive symptoms: Trouble with memory, focus, or decision-making.

A psychiatrist diagnoses schizophrenia through:

• Clinical interviews – Discussing symptoms and medical history.

• Observation – Assessing thought patterns, speech, and behavior.

• Exclusion of other conditions – Ruling out substance use, mood disorders, or neurological diseases.
  There is no single blood test or brain scan that confirms schizophrenia.

Currently, there is no complete cure, but effective treatment can help manage symptoms and improve quality of life. Many people live productive lives with the right support.

Treatment usually includes:

• Medications – Antipsychotics to reduce symptoms.

• Therapies – Cognitive Behavioral Therapy (CBT), social skills training.

• Support services – Vocational training, peer groups, and family education.

No. This is a common myth. Multiple Personality Disorder (now called Dissociative Identity Disorder) is different and involves having two or more distinct identities. Schizophrenia is about altered reality perception and disorganized thinking.

They can:

• Learn about the condition.

• Encourage treatment and healthy habits.

• Offer emotional support without judgment.

• Be patient and understanding.

Yes—many can, especially with early diagnosis, proper treatment, and community support. The goal of treatment is to help individuals lead fulfilling, independent lives.

Schizophrenia is a chronic psychotic disorder characterized by at least two of the following symptoms, each present for a significant portion of time during a 1-month period (or less if successfully treated), with at least one being (1), (2), or (3):

1. Delusions

2. Hallucinations

3. Disorganized speech

4. Grossly disorganized or catatonic behavior

5. Negative symptoms (e.g., diminished emotional expression, avolition)

Additional criteria:

• Continuous signs of disturbance for ≥6 months, including ≥1 month of active-phase symptoms.

• Functional impairment in work, relationships, or self-care.

• Symptoms not better explained by schizoaffective disorder, mood disorder, substance use, or medical condition.

• Neurodevelopmental hypothesis – Disrupted brain development in utero/early life.

• Dopamine hypothesis – Hyperactivity of mesolimbic dopamine pathways (positive symptoms) and hypoactivity of mesocortical pathways (negative/cognitive symptoms).

• Glutamate hypothesis – NMDA receptor hypofunction contributing to cognitive deficits.

• Genetic predisposition – Heritability ~80%; risk increases with degree of relation.

• Environmental factors – Perinatal hypoxia, viral infections, cannabis use in adolescence, psychosocial stressors.

• • Structured clinical interviews: SCID-5, MINI.

  • Mental Status Examination (MSE): Formal thought disorder, affect, insight.

  • Neuroimaging: MRI/CT to exclude lesions, atrophy patterns.

  • Laboratory workup: CBC, electrolytes, thyroid function, syphilis serology, HIV, urine toxicology.

  • Neuropsychological testing: For baseline cognitive function.

• • a. Pharmacological

    • First-line: Second-generation antipsychotics (SGAs) – risperidone, olanzapine, aripiprazole, quetiapine.

    • Acute agitation: IM haloperidol + promethazine OR IM olanzapine.

    • Treatment-resistant schizophrenia (TRS): Clozapine after failure of ≥2 antipsychotic trials.

    • Adjuncts: Antidepressants for comorbid depression, mood stabilizers for aggression.

    b. Psychosocial interventions

    • CBT for psychosis (CBTp)

    • Social skills training, supported employment

    • Family psychoeducation to reduce relapse

    c. Early intervention

    • Coordinated Specialty Care (CSC) for first-episode psychosis improves long-term outcomes.

• • Favorable:

    • Female gender

    • Acute onset

    • Older age at onset

    • Good premorbid functioning

    • Predominance of positive symptoms
      Poor:

    • Male gender

    • Gradual onset

    • Early onset (<18 years)

    • Predominance of negative symptoms

    • Comorbid substance abuse

Schizophrenia: Mood episodes present for a minority of the illness duration.

• • • Schizoaffective: Mood episodes present for the majority of the illness duration along with psychotic symptoms.

• Metabolic monitoring: BMI, fasting glucose, lipid profile (SGAs can cause weight gain, metabolic syndrome).

• Tardive dyskinesia monitoring: AIMS scale every 6–12 months.

• Relapse prevention: Long-acting injectables (paliperidone palmitate, aripiprazole LAI).