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Schizophrenia in adults: Clinical manifestations, course, assessment, and diagnosis

Bernard A Fischer, MD
Robert W Buchanan, MD
Section Editor
Stephen Marder, MD
Deputy Editor
Richard Hermann, MD


Schizophrenia is a psychiatric disorder involving chronic or recurrent psychosis. It is commonly associated with impairments in social and occupational functioning [1]. It is among the most disabling and economically catastrophic medical disorders, ranked by the World Health Organization as one of the top ten illnesses contributing to the global burden of disease [2].

Characteristics of schizophrenia typically include positive symptoms such as hallucinations or delusions, disorganized speech, negative symptoms such as a flat affect or poverty of speech, and impairments in cognition including attention, memory and executive functions. A diagnosis of schizophrenia is based on the presence of such symptoms, coupled with social or occupational dysfunction, for at least six months in the absence of another diagnosis that would better account for the presentation.

This topic discusses clinical manifestations, assessment, diagnosis, and course of schizophrenia. The epidemiology and pathogenesis of schizophrenia are discussed separately. Anxiety, depression, and substance abuse in schizophrenia are discussed separately. The treatments for schizophrenia are discussed separately, as are other psychotic disorders. Schizophrenia in children is also reviewed separately. (See "Schizophrenia in adults: Epidemiology and pathogenesis" and "Depression in schizophrenia" and "Anxiety in schizophrenia" and "Pharmacotherapy for schizophrenia: Acute and maintenance phase treatment" and "Pharmacotherapy for schizophrenia: Side effect management" and "Co-occurring schizophrenia and substance use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment and diagnosis" and "Psychosocial interventions for schizophrenia" and "Schizophrenia in children and adolescents: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Pharmacotherapy and psychosocial interventions for schizophrenia in children and adolescents".)


Schizophrenia is a syndrome. People with schizophrenia generally present with several symptom domains (ie, areas of distinct psychopathology):

Positive symptoms

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Literature review current through: Dec 2017. | This topic last updated: Feb 27, 2017.
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