Schizophrenia
BASICS
A severe and persistent mental illness characterized by delusions, hallucinations, disorganization of thought and behavior, cognitive dysfunction, and impairment in reality testing
DESCRIPTION
Major psychiatric disorder with a variable course, typically involving prodromal, active, and residual psychotic symptoms with disturbances in thought, speech, affect, behavior, and perception
EPIDEMIOLOGY
Prevalence
- Worldwide prevalence 7.2 per 1,000 people
- Age of onset: typically <30 years, earlier in males (late teens to mid-20s) than females (early 20s to early 30s)
ETIOLOGY AND PATHOPHYSIOLOGY
- Overstimulation of mesolimbic dopamine D2 receptors, deficient prefrontal dopamine, and aberrant prefrontal glutamate (NMDA) activity results in perceptual disturbances, disordered thought process, and cognitive impairments.
- Two genes, SRRM2 and AKAP11, have been discovered to be associated with an increased risk of schizophrenia while the gene PLCO demonstrates a shared increased risk of both schizophrenia and autism.
Genetics
If first-degree biologic relative has schizophrenia, risk is 8–10%.
RISK FACTORS
- Antenatal risk factors include prenatal infection or malnutrition, obstetric complications leading to hypoxia, winter births, postnatal infections requiring hospitalization, urban birth, and advanced paternal age.
- Risk factors across the lifespan include adolescent cannabis use, childhood trauma, urban residence, autoimmune disorders, severe and repeated stress, lower socioeconomic status, minority status, being a first- or second-generation immigrant, inadequate social support.
GENERAL PREVENTION
Educate all patients on the risks around marijuana use.
COMMONLY ASSOCIATED CONDITIONS
- Nicotine dependence (>50%) and substance use disorders
- Metabolic syndrome, diabetes mellitus
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Citation
Domino, Frank J., et al., editors. "Schizophrenia." 5-Minute Clinical Consult, 34th ed., Wolters Kluwer, 2026. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688698/all/Schizophrenia.
Schizophrenia. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2026. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688698/all/Schizophrenia. Accessed July 17, 2025.
Schizophrenia. (2026). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (34th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688698/all/Schizophrenia
Schizophrenia [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2026. [cited 2025 July 17]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688698/all/Schizophrenia.
* Article titles in AMA citation format should be in sentence-case
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T1 - Schizophrenia
ID - 1688698
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688698/all/Schizophrenia
PB - Wolters Kluwer
ET - 34
DB - Medicine Central
DP - Unbound Medicine
ER -