table of contents
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
You can find several quick tests for schizophrenia online, but take them with caution—they’re not validated or reliable.
While it may be tempting to get fast results for something you’re curious about, a diagnosis of schizophrenia can only be made by a licensed healthcare professional after a thorough evaluation.
Nearly 2% of people in the United States have schizophrenia, which means it’s more common than you might have thought. Living with schizophrenia is different for each person, but common symptoms include hallucinations, delusions, and distorted thoughts that lead to noticeable changes in behavior.
Various treatment options exist to manage symptoms and reduce the frequency of episodes. However, there’s no simple blood test or scan that can diagnose the condition.
Let’s look at the signs of schizophrenia and what tools healthcare professionals use to help make a diagnosis.
Get help with anxiety and depression
Ro Mind offers access to customized treatment plans and check‑ins with a U.S.-licensed healthcare provider to support your mental health.
Tools and early indicators of schizophrenia
Several screening tools can help identify schizophrenia in its early stages, even a few years before someone experiences an episode of psychosis (Goulding, 2013).
Before the onset of schizophrenia, a person might show symptoms––like noticeable changes in social habits––but have yet to experience full-on psychosis. These tools can help detect someone at extremely high risk for developing schizophrenia in the future, though it’s not a guarantee.
The most widely used tool is a 92-item questionnaire called the Structured Interview for Prodromal Syndromes, or SIPS for short. Between 20-40% of people identified as ultra-high risk from the SIPS tool end up experiencing psychosis within four years (George, 2017).
Other screening tests include Personal Assessment and Crisis Evaluation (PACE) and the Criteria of Prodromal Syndromes (COPS) (Hany, 2020).
These tools will look comprehensively at feelings and behaviors over time—not just a few months. None of these are perfect at predicting schizophrenia but can be an important piece of the diagnostic puzzle.
How is schizophrenia diagnosed?
The first step is to get a complete picture of your mental and physical health by looking at things like family history, past medical history, drug use, memory problems, and head injuries.
The DSM-5 suggests schizophrenia if two or more of the following symptoms occur for a significant amount of time within one month and continue consistently or on and off for at least six months. A diagnosis of schizophrenia requires at least two of the following five symptoms and must include at least one of the first three:
- Delusions: Persistent beliefs in things that are not true.
- Hallucinations: Most commonly are auditory, meaning hearing voices or sounds that aren’t there.
- Disorganized speech: Speech that is nervous, bizarre, slow, or doesn’t seem to make sense.
- Grossly disorganized or catatonic behavior: Being unresponsive or making the same repetitive motions over and over.
- Extreme lack of energy or motivation
Experiencing a single episode that fits this diagnosis isn’t usually enough to make a diagnosis of schizophrenia, though. Symptoms must occur over at least six months (though they might not be active that entire time) and impede work or social relationships to constitute a diagnosis (Hany, 2020; Patel, 2014).
Are there lab tests for schizophrenia?
Certain lab tests, like blood tests, can rule out other causes of your symptoms. Your provider may analyze a urine or blood sample to look for specific diseases that can cause some of the same symptoms as schizophrenia. They also may look at a CT scan or MRI of your brain to rule out a neurological issue (Hany, 2020).
Signs and symptoms of schizophrenia
There’s a set of symptoms associated with schizophrenia, but some people may experience more or less of certain ones.
For example, one aspect of schizophrenia is catatonic behavior, which includes being unresponsive or performing repetitive motions. Some people may have frequent episodes characterized by catatonic behavior, and others could have completely different symptoms, like hearing voices that aren’t there (Hany, 2020; Jain, 2021).
Schizophrenia symptoms typically begin in late teen years or early adulthood but can appear at any time. Characteristic signs may include a combination of:
- Distorted thoughts or perceptions
- Changes in personality
- Acting out of character
- Withdrawing from social activities or relationships
- Decrease in motivation
- Talking slower than usual
- Self-harm or suicide attempts
Schizophrenia’s wide range of symptoms means it’s sometimes be mistaken for other conditions that also cause distorted thoughts and perceptions. These can include (Hany, 2020; Ajitkumar, 2021; Zafar, 2020):
- Huntington’s disease
- Parkinson’s disease
- Wilson’s disease
- Porphyria, a rare disorder related to chemicals in red blood cell production
Risk factors for schizophrenia
Researchers have determined things that increase your risk for schizophrenia. However, it doesn’t mean you’ll develop the condition.
Here are some of the risk factors for schizophrenia (Belbasis, 2018):
- Using cannabis
- Extremely stressful events as a child or adult
- Having a low level of folate (a B vitamin) in your blood
- Issues related to your development before you were born or during birth, such as being delivered by emergency C-section or your mother having high blood sugar during pregnancy
- Family history of schizophrenia
There is a genetic component to schizophrenia, but having a family member with schizophrenia doesn’t mean you’ll have it. Only about 10% of people who have a parent or sibling with schizophrenia will develop it as well (Patel, 2014).
While diagnosing schizophrenia is currently limited to observing behavior, maybe in the future researchers will be able to identify biomarkers—distinct molecules that might serve as diagnostic tools to make early diagnosis easier and increase treatment options (Tomasik, 2016).
- Ajitkumar, A., De Jesus, O., Huntington Disease (Updated 2021, February 7). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559166/.
- Belbasis, L., Köhler, C. A., Stefanis, N., Stubbs, B., van Os, J., Vieta, E., Seeman, M. V., Arango, C., Carvalho, A. F., & Evangelou, E. (2018). Risk factors and peripheral biomarkers for schizophrenia spectrum disorders: an umbrella review of meta-analyses. Acta Psychiatrica Scandinavica, 137(2), 88–97. doi: 10.1111/acps.12847. https://pubmed.ncbi.nlm.nih.gov/29288491/
- Duque-Serrano, L., Patarroyo-Rodriguez, L., Gotlib, D., & Molano-Eslava, J. C. (2018). Psychiatric Aspects of Acute Porphyria: a Comprehensive Review. Current Psychiatry Reports, 20(1), 5. doi: 10.1007/s11920-018-0867-1. https://pubmed.ncbi.nlm.nih.gov/29392446/
- George, M., Maheshwari, S., Chandran, S., Manohar, J. S., & Sathyanarayana Rao, T. S. (2017). Understanding the schizophrenia prodrome. Indian Journal of Psychiatry, 59(4), 505–509. doi: 10.4103/psychiatry.IndianJPsychiatry_464_17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806335/
- Goulding, S. M., Holtzman, C. W., Trotman, H. D., Ryan, A. T., Macdonald, A. N., Shapiro, D. I., Brasfield, J. L., & Walker, E. F. (2013). The prodrome and clinical risk for psychotic disorders. Child and Adolescent Psychiatric Clinics of North America, 22(4), 557–567. doi: 10.1016/j.chc.2013.04.002. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140174/
- Guerrero-Jiménez, M., Carrillo de Albornoz Calahorro, C. M., & Gutierrez Rojas, L. (2019). Wilson disease and psychiatric symptoms: A brief case report. General Psychiatry, 32(3), e100066. doi: 10.1136/gpsych-2019-100066. https://pubmed.ncbi.nlm.nih.gov/31423476/
Hany, M., Rehman, B., Azhar, Y., et al. Schizophrenia (2020, December 8). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539864/
Jain, A., Mitra, P., Catatonic Schizophrenia (Updated 2021, Feb 27). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK563222/
Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: overview and treatment options. Pharmacology & Therapeutics, 39(9), 638–645. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/
Peng, S., Li, W., Lv, L., Zhang, Z., & Zhan, X. (2018). BDNF as a biomarker in diagnosis and evaluation of treatment for schizophrenia and depression. Discovery Medicine, 26(143), 127–136. https://pubmed.ncbi.nlm.nih.gov/30586536/
Tomasik, J., Rahmoune, H., Guest, P. C., & Bahn, S. (2016). Neuroimmune biomarkers in schizophrenia. Schizophrenia Research, 176(1), 3–13. doi: 10.1016/j.schres.2014.07.025. https://pubmed.ncbi.nlm.nih.gov/25124519/
Zafar, S., Yaddanapudi, S.S., Parkinson Disease (Updated 2020, August 10). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470193/.