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Schizophrenia

Definition

Schizophrenia is a serious and potentially disabling mental disorder that affects how a person thinks, feels, and behaves. Additional information can be found on the NIMH Health Topics page on Schizophrenia.

Prevalence of Schizophrenia

The prevalence rates for such a rare and complex disorder are difficult to generate using typical household surveillance strategies. A diagnosis of schizophrenia requires a thorough assessment by a clinician. To meet diagnostic criteria for schizophrenia, continuous signs of disturbance must persist for at least six months.

Prevalence of Schizophrenia in Adults

The prevalence of schizophrenia is less than 1% of the population. This estimate is based on data from three publications.1, 2, 3

Prevalence of Schizophrenia in Children

Schizophrenia in children is rare. However, schizophrenia can emerge at a very early age, even before puberty.4

Disease Burden and Affected Populations

Age of Onset

Schizophrenia affects men somewhat more frequently than women.2

  • Schizophrenia often first appears in men in their late teens or early twenties.
  • Onset in women may be later, generally appearing in their twenties or early thirties.

Premature Mortality

Individuals with schizophrenia have an increased risk of premature mortality (death at a younger age than the general population).

  • Among people with schizophrenia, the estimated average potential life lost is 28.5 years.5
  • Medical conditions that may contribute to the higher mortality rate include heart disease, cancer, pulmonary disease, and diabetes.5
  • Individuals with schizophrenia have a 5% lifetime suicide risk. This rate is far greater than the general population.6

Treatment

Coordinated specialty care (CSC) is a recovery-oriented treatment program for people experiencing a first episode psychosis, a condition which often accompanies a diagnosis of schizophrenia.

  • CSC uses a team of specialists who work with the client to create a personal treatment plan including: psychotherapy, medication management geared to individuals with first episode psychosis, family education, case management, and work or education support, depending on the individual’s needs and preferences.
  • The client and the CSC team work together to make treatment decisions, involving family members as much as possible.
  • The goal is to link the client with a CSC team as soon as possible after psychotic symptoms begin.

The NIMH Recovery After an Initial Schizophrenia Episode (RAISE) initiative compared the effectiveness of CSC treatment for people who were experiencing first episode psychosis to usual community care. Findings from the initiative include:

  • Getting people into treatment quickly is very important for recovery.7
  • CSC for first episode psychosis works and can be implemented in clinics across the United States.8
  • CSC is cost effective.9

Data Sources

  1. Kessler RC, Birnbaum H, Demler O, Falloon IR, Gagnon E, Guyer M, Howes MJ, Kendler KS, Shi L, Walters E, Wu EQ. The prevalence and correlates of nonaffective psychosis in the National Comorbidity Survey Replication (NCS-R). Biol Psychiatry. 2005 Oct 15;58(8):668-76. PMID: 16023620
  2. McGrath J, Saha S, Chant D, Welham J. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008;30:67-76. PMID: 18480098
  3. Saha S, Chant D, Welham J, McGrath J. A systematic review of the prevalence of schizophrenia. PLoS Med. 2005 May;2(5):e141. PMID: 15916472
  4. Hollis C, Rapoport J (2008). Child and Adolescent Schizophrenia. In D Weinberger, P Harrison (Eds.). Schizophrenia (3rd ed., pp. 24-46). London: Blackwell. doi/10.1002/9781444327298
  5. Olfson M, Gerhard T, Huang C, Crystal S, Stroup TS. Premature Mortality Among Adults With Schizophrenia in the United States. JAMA Psychiatry. 2015 Dec;72(12):1172-81. PMID: 26509694
  6. Hor K, Taylor M. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol. 2010 Nov;24(4 Suppl):81-90. PMID: 20923923
  7. Kane JM, Robinson DG, Schooler NR, Mueser KT, Penn DL, Rosenheck RA, Addington J, Brunette MF, Correll CU, Estroff SE, Marcy P, Robinson J, Meyer-Kalos PS, Gottlieb JD, Glynn SM, Lynde DW, Pipes R, Kurian BT, Miller AL, Azrin ST, Goldstein AB, Severe JB, Lin H, Sint KJ, John M, Heinssen RK. Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program. Am J Psychiatry. 2016 Apr 1;173(4):362-72. PMID: 26481174
  8. Marino L, Nossel I, Choi JC, Nuechterlein K, Wang Y, Essock S, Bennett M, McNamara K, Mendon S, Dixon L. The RAISE Connection Program for Early Psychosis: Secondary Outcomes and Mediators and Moderators of Improvement. J Nerv Ment Dis. 2015 May;203(5):365-71. PMID: 25900546
  9. Rosenheck R, Leslie D, Sint K, Lin H, Robinson DG, Schooler NR, Mueser KT, Penn DL, Addington J, Brunette MF, Correll CU, Estroff SE, Marcy P, Robinson J, Severe J, Rupp A, Schoenbaum M, Kane JM. Cost-Effectiveness of Comprehensive, Integrated Care for First Episode Psychosis in the NIMH RAISE Early Treatment Program. Schizophr Bull. 2016 Jul;42(4):896-906. PMID: 26834024

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