Schizophrenia is a mental health disorder that affects how people perceive the world, think about themselves and others, and experience emotions. About 7-8 people out of every 1,000 individuals will develop schizophrenia, so it is not a common mental health condition like depression or anxiety. Men are slightly more likely than women to develop schizophrenia, and delusions and hallucinations typically begin between 16 and 30 years of age. Rarely, a person may develop the hallmark symptoms, hallucinations and delusions, in childhood or later in life, which can make the condition more difficult to diagnose.

People who struggle with schizophrenia are more likely to harm themselves than others, although substance abuse can increase the risk of violence toward other people or animals. It is unfortunately common for people with untreated schizophrenia to develop substance use disorders, which intensifies the symptoms of the condition as well as the risk of violence and suicide.

How Schizophrenia Is Diagnosed

In diagnosing schizophrenia, medical professionals use a variety of methods.

  • Symptoms

    In order for a person to meet the criteria for a schizophrenia diagnosis, they must experience at least two mental health symptoms most of the time for a month, and some mental disturbance for six months. Symptoms include:

    • Delusions: false beliefs that the person cannot or will not give up
    • Hallucinations: a sensory experience (generally visual or auditory) that the individual experiences as real but is not real
    • Disordered speech and behavior
    • Being catatonic, or in a coma-like daze
    • Hyperactive or otherwise strangely manic behavior
  • Physical Exam

    If the person displays symptoms that may be schizophrenia, a physician will conduct a thorough exam. This helps to rule out any other reason for the mental health issues, including a tumor, hormone instability, or substance abuse. The physical exam may include tests and screenings like a CAT scan, MRI, or bloodwork.

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  • Psychiatric Evaluation

    Once underlying physical changes have been ruled out, the person struggling with symptoms of schizophrenia must receive an official diagnosis from a psychologist. The professional will use criteria from the DSM-5 to accurately diagnose the person with this, or potentially a different, mental health condition.

  • Psychological Tests

    A therapist may use a series of questions to determine if the client has schizophrenia or another illness that can appear like schizophrenia, including bipolar disorder or schizoaffective disorder. The psychological questions will also help determine which type of schizophrenia the individual suffers from.There are five types of schizophrenia. They are:

    • Paranoid subtype: Hallucinations or delusions revolve around the person being plotted against, persecuted, or betrayed by loved ones. Hallucinations and delusions are prominent, but disorganized speech, flattened emotional reactions, catatonia, and other symptoms are less common.
    • Disorganized subtype: This form of schizophrenia involves disordered speech and thoughts but few hallucinations or delusions.
    • Catatonic subtype: Bizarre and abnormal behaviors characterize this type of schizophrenia; most commonly, the person exhibits little activity of any kind or hyperactivity.
    • Undifferentiated subtype: No one symptom dominates, but symptoms of schizophrenia are present.
    • Residual subtype: This type of schizophrenia is typically associated with people who had more prominent symptoms of schizophrenia at one time but no longer suffer from them as intensely; however, milder symptoms are still present.

Treatment for Schizophrenia and Substance Abuse

People who struggle with any mental health issue, including schizophrenia, are at a greater risk of developing problems with substance abuse. Whether there are hallucinations or delusions related to ingesting substances, or the person abuses substances to reduce the impact of the symptoms, these two disorders often co-occur.

When a person with schizophrenia enters a rehabilitation program, it is important that the mental health issue is treated alongside the substance abuse. Treating one disorder without treating the other will not facilitate recovery. It is also important to know how the substances of abuse may have impacted the ability of antipsychotics to help the person manage symptoms of their mental health problem. An integrated treatment team will effectively manage the care plan for the individual, ensuring the best chances of recovery on all fronts.