The ultimate guide to schizophrenia

The ultimate guide to schizophrenia
Schizophrenia is a psychiatric disorder characterized by persistent cognitive deficits, frequent hallucinations and/or delusions, and social withdrawal. Here's what you need to know.
Written by Orchid Team
Medically reviewed by Dr. Vanessa Cutler
  • Dr. Vanessa Cutler, MD MPH, is a board-certified adult and child psychiatrist. She is an assistant clinical professor of psychiatry at NYU Langone and Medical Director of Behavioral Health at Four Winds Hospital in Saratoga Springs in addition to holding privileges at numerous hospitals across New York State.

What is schizophrenia?

Schizophrenia is a psychiatric disorder characterized by persistent cognitive deficits, frequent auditory or visual hallucinations and/or delusions, and social withdrawal. Importantly, these symptoms must not be caused by recreational drug use (such as methamphetamine), alcohol or a medication, and must affect someone severely for at least 6 months

What are the risk factors for schizophrenia?

  • family history
  • genetics
  • environment

How does family history influence risk of schizophrenia?

A family history of schizophrenia increases the likelihood of developing the disease. For example, someone with a parent or sibling with schizophrenia has a 10% chance of developing schizophrenia. And if both parents have schizophrenia, the risk is 50%. These are significantly higher than the average risk of 0.5%.

How do genetics influence risk of schizophrenia?

The exact cause of schizophrenia is unknown but a study conducted on 31,524 pairs of twins estimated the disease to be about 65.1 to 88.2% heritable. There have been multiple studies that have identified genetic mutations in people with schizophrenia concentrated in brain neurons and brain imaging studies have found reductions in brain volume in specific areas of the brain, though this is still poorly understood.

How does the environment influence the risk of schizophrenia?

There may be a connection between traumatic childhood events and schizophrenia and so reducing childhood trauma may reduce the risk of schizophrenia, but there is no firm evidence for this. Other environmental risk factors include exposure to viruses in-utero during fetal development (such as influenza), and heavy cannabis use during adolescence. However, these associations may not be causal, and should be viewed with caution.

At what age is schizophrenia usually diagnosed?

About 0.45% of the American population have schizophrenia, which is typically diagnosed in the mid-early 20s for males, and the late 20s to early 30s for females.

How is it diagnosed? 

Schizophrenia can be challenging to distinguish from other psychiatric disorders. A psychiatrist will want to know the duration and type of symptoms, prior medical history and family history.  Patients with schizophrenia often have disorganized speech and behaviors, so observing them is also important. A medical workup to check for drugs or medical conditions that may be causing psychosis may also be performed and is an important part of the diagnostic assessment.  

What are some complications of schizophrenia?

People with schizophrenia have a lifespan that is 15 to 25 years shorter on average. People with schizophrenia are at a much higher risk for a suicide attempt, as well as cardiovascular disease. The cognitive deficits associated with schizophrenia are especially predictive of later functioning, and are also some of the symptoms that are the least responsive to treatment.

Is there anything I can do to reduce my child’s genetic risk?

As explained in the schizophrenia whitepaper, genetics play an important role in determining the risk for developing schizophrenia. Using Orchid’s embryo scoring, you can prioritize the embryo with the lowest genetic risk for schizophrenia and potentially reduce their risk. 

Is there anything I can do to reduce my risk of schizophrenia?

Intervening to prevent schizophrenia in at-risk individuals is an active area of research with no firm evidence yet to guide efforts though avoiding drugs that can trigger psychosis, particularly cannabis and psychedelics is recommended.

How is schizophrenia treated?

Once someone has been diagnosed with schizophrenia, there are medical and social interventions to manage symptoms and improve functioning. 

Treatment of schizophrenia is complicated and requires a multidisciplinary team.  Typically, treatment consists of acute treatment for psychosis and relapse prevention, as well as maintenance therapy after symptoms have decreased in frequency, intensity or have resolved. The main medications used are antipsychotics, which vary in effectiveness and also carry risk of side effects.

Psychotherapy is also recommended. People with schizophrenia should also be connected with community support programs.


  1. People with schizophrenia may experience hallucinations, cognitive deficits, and withdraw socially, all of which has a severe impact on daily functioning and longevity.
  2. Sustained psychiatric treatment and social support can help most people with schizophrenia but many will continue to relapse throughout the lifespan.
  3. There are no proven ways to prevent schizophrenia in those at-risk, but abstinence from cannabis and other illicit drugs,  early intervention and treatment may reduce the severity of illness.

Where can I learn more?

  1. The National Institutes of Mental Health (NIMH) has resources

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