Schizophrenia onset: When does it usually develop?

Dr. Jenni Jacobsen, PhD
Author: Dr. Jenni Jacobsen, PhD Medical Reviewer: Morgan Blair Last updated:

Schizophrenia is a mental health disorder associated with psychosis. Symptoms of schizophrenia include auditory and visual hallucinations, delusions, and disruptions to thinking, perception, and behavior [1]. The age of onset for schizophrenia generally in early adulthood [2].

What is the average age of onset of schizophrenia?

Schizophrenia onset can vary from person-to-person, but research gives us a general idea of when a person develops this mental health condition. According to a report that analyzed the results of 192 different epidemiological studies across the globe, the median age of onset for schizophrenia is 25 years of age [3]. This means that half of people develop schizophrenia before this age, and half have an age of onset after 25.

The study also found that just 3% of people with schizophrenia had an age of onset before 14; 12.3% developed the condition before age 18, and 47.8% developed it before age 25 [3].

Based upon these figures, it is uncommon for schizophrenia symptoms to appear before the early teen years, and only a small percentage of people will have an age of onset before 18. It is more common to develop schizophrenia during the mid-twenties. According to the National Alliance on Mental Illness (NAMI), the average age of onset for schizophrenia is in the late teens to early 20s for men and the late 20s to early 30s for women [2].

What is early-onset schizophrenia?

Early-onset schizophrenia is a term used to describe cases of schizophrenia that develop earlier than expected, or earlier than the norm. The term early-onset schizophrenia is typically used to describe schizophrenia that presents prior to age 18 [4].

Another form of early-onset schizophrenia is childhood-onset schizophrenia, which is diagnosed when a person shows symptoms before the age of 13 [4].

When a person develops early-onset schizophrenia, there are generally some warning signs that are indicative of future psychosis. In these early stages of the psychotic disorder, a person is said to be in the prodrome phase. During this phase, a person’s overall functioning begins to decline. They may stop caring for personal hygiene. For children progressing toward early-onset schizophrenia, academic and social functioning may be impaired [4].

Some other early warning signs of schizophrenia include [5]:

  • Blurred vision
  • Hypersensitivity to light and/or sound
  • Transitory blindness
  • Difficulty with receptive language
  • Perseveration of thought
  • Difficulty thinking
  • Intrusive thoughts
  • Feeling detached from surroundings

Later in the prodrome phase, a person may show some of the following schizophrenia warning signs [5]:

  • Suspicious or paranoid thoughts
  • Odd beliefs and speech
  • Strange thinking patterns
  • Unusual perceptual experiences
  • Ideas of reference (believing that irrelevant details are directly related to oneself)

What is late-onset schizophrenia?

Late-onset schizophrenia is defined as schizophrenia symptoms that appear after 40 years of age. After 60 years of age, it is referred to as very late-onset schizophrenia [5].

Since it is more common for schizophrenia symptoms to present in early adulthood, late-onset schizophrenia is simply the development of schizophrenia later than expected or later than the norm.

Can you prevent the onset of schizophrenia?

There is no surefire way to prevent schizophrenia. Rather, the condition can be managed with early treatment and other measures to help promote optimal mental health functioning. Also, it is important to be aware of risk factors for schizophrenia, which can include low birth weight, having a parent with schizophrenia, and experiencing pregnancy and birth-related complications, such as being born to a mother with preeclampsia or gestational diabetes or being born via emergency C-section [1].

If you have early warning signs of schizophrenia and/or multiple risk factors for the condition, it’s important to seek treatment to address symptoms and reduce the risk of future complications. Schizophrenia is often treated with an antipsychotic medication. Behavioral treatment, including cognitive behavioral therapy, can also be helpful and can reduce the risk of a relapse into active psychosis once a person is stabilized on medication [1].

While there is no guaranteed way to prevent or cure schizophrenia, there is evidence that early intervention and treatment can reduce the severity of the condition and lower the risk of complications. Encouraging people to seek help in the early stages of the mental disorder reduces the length of time that psychotic symptomss remain untreated. Early treatment of psychosis is important because untreated psychosis is linked to worse outcomes in patients with schizophrenia [7].

Once a patient is stabilized, there are numerous interventions that can reduce the risk of relapse. For example, studies have shown that family treatment, relapse prevention programming, cognitive behavioral therapy, and psychoeducation for both family and patient are effective for reducing relapse [8]. This means it may be impossible to prevent schizophrenia onset, but it is possible to reduce the risk of future episodes with quality treatment.

Resources
  1. Hany, M., Rehman, B., Azhar, Y., & Chapman, J. (2023).National Library of Medicine. Retrieved May 2, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK539864/
  2. National Alliance on Mental Illness. (n.d.). Schizophrenia. Retrieved May 2, 2023, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizophrenia
  3. Solmi, M., et al. (2022). Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry, 27, 281-295. https://doi.org/10.1038/s41380-021-01161-7
  4. Kendhair, J., Shankar, R., & Young Walker, L. (2016). A review of childhood-onset schizophrenia.Focus: The Journal of Lifelong Learning in Psychiatry, 14(3), 328-332. doi: 10.1176/appi.focus.20160007
  5. Ruhrmann, S., Schultze-Lutter, F., Klosterkötter, J. (2003). Early detection and intervention in the initial prodromal phase of schizophrenia. Pharmacopsychiatry, 36,162-167. DOI: 10.1055/s-2003-45125
  6. Chen, L., Selvendra, A., & Castle, D. (2018). Risk factors in early and late onset schizophrenia. Comprehensive Psychiatry, 80, 155-162. https://doi.org/10.1016/j.comppsych.2017.09.009
  7. Yung, A.R., et al. (2007). The prevention of schizophrenia. International Review of Psychiatry, 6(19), 633-646. https://doi.org/10.1080/09540260701797803
  8. Bighelli, Irene, et al. (2021). Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. The Lancet Psychiatry, 8(11), 969-980. https://doi.org/10.1016/S2215-0366(21)00243-1
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Dr. Jenni Jacobsen, PhD
Author Dr. Jenni Jacobsen, PhD Medical Reviewer, Writer

Dr. Jenni Jacobsen, PhD is a medical reviewer, licensed social worker, and behavioral health consultant, holding a PhD in clinical psychology.

Published: Jul 11th 2023, Last edited: Feb 21st 2024

Morgan Blair
Medical Reviewer Morgan Blair MA, LPCC

Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.

Content reviewed by a medical professional. Last reviewed: Jul 11th 2023