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Statistics and Course of Schizophrenia

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D., edited by Kathryn Patricelli, MA

graph Schizophrenia is not a terribly common disease but it can be a serious and life-long one. Between 0.3% and 0.7% of the population is diagnosed with schizophrenia. According to the World Health Organization (WHO) approximately 21 million people worldwide have schizophrenia (12 million males and 9 million females).

Schizophrenia can affect people throughout the lifespan. However, it is most likely to first appear in the late teen years and the mid-30s. It is fairly rare for children and older adults to develop schizophrenia, but it does happen. The rate of diagnosis of new cases increases in the teen years, reaching a peak of vulnerability between the ages of 16 and 25 years. Men and women show different patterns for developing the disorder. Males are more likely to have their first episode in the early to mid-20s. Females have two points where the first episodes are most likely to happen. The first is in the late-20s and the second is after 40 years of age.

Course of Illness

Before the full onset of schizophrenia happens, there is typically an earlier period where odd behaviors and experiences, such as anxiety, restlessness and hallucinations begin to happen. However, they are not yet at their fullest force. There may be a gradual loss of reality. Many people with schizophrenia describe the start of odd feelings, thoughts and understandings a few months before anyone else sees the evidence of them. It can be quite difficult to recognize schizophrenia during this early stage. The person may have been hearing criticizing voices and experiencing delusional thoughts for some time. However, these symptoms may not have been overwhelming or frightening enough to have caused them to break down and act in a bizarre manner. People experiencing these symptoms for the first time may be able to hide them for a while. This becomes more difficult as they begin to lose touch with reality and their actions begin to reflect their inner troubles.

Schizophrenia is not generally recognized to be happening until after truly odd and irrational behaviors are expressed during what is called a "psychotic break", or "first break." Though the person's internal experience during hallucinations or delusions may be terrifying, it is the outward symptoms of the psychotic break that are noticed by family members and others. These include changes in:

  • self-care
  • sleeping or eating patterns
  • weakness
  • lack of energy
  • headaches
  • changes in school or work performance
  • strange sensations
  • confused, strange, or bizarre thinking that gets expressed as bizarre behavior

The actual break with reality may happen before people around the person have noticed that something is seriously wrong. When schizophrenia does occur, it often becomes an ongoing condition that continues throughout the rest of the person's life with different levels of intensity. The "first break" may be the last break if the case of schizophrenia is mild and if treatment happens promptly and is continued as directed by a psychiatrist (a medical doctor specializing in mental health issues). Typically, however, the first break leads to a pattern of 'residual' and 'active' phases In the residual phase, the person is mostly recovered and symptom free. Then new periods happen where symptoms return. This rise and fall of symptoms often continues for the rest of the person's life.