Schizophrenia

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    Louie Neri

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    Morgan Pfiffner, Natalka Roshak
    Last Updated: October 13, 2024

    Schizophrenia is a brain condition that may cause auditory and/or visual hallucinations, delusions, difficulties with emotions and cognition, and verbal communication problems. These symptoms manifest between the ages of 16 and 30.

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    Schizophrenia falls under the Mental Health category.

    10 references on this page
    8,723 participants in 29 trials and 8 meta-analyses

    What is schizophrenia?

    Schizophrenia is a severe mental illness that interferes with a person’s thinking and perception of the world around them. Even though schizophrenia affects about 1% of the world's population, it is one of the top 20 causes of disability worldwide.[1][2][3]

    Is schizophrenia the same as psychosis?

    What are the main signs and symptoms of schizophrenia?

    Symptoms of schizophrenia are broken down into two main categories:

    • Positive symptoms — experiences that add to existing emotions or thoughts — such as hallucinations, delusions, and disordered thinking.

    • Negative symptoms — experiences that subtract from emotions or thoughts — such as reduced speech, lack of motivation, and decreased emotional expression.

    Catatonia, which is characterized by repetitive non-goal directed movements, unresponsiveness, and episodes of overactivity or immobility, is another common symptom of schizophrenia. Additionally, cognitive impairment, which can affect things like memory, processing speed, and attention, has recently been recognized as a symptom of schizophrenia. Symptoms of schizophrenia usually begin to appear between the ages of 16 and 30.[4][1]

    What’s the difference between positive and negative symptoms?

    How is schizophrenia diagnosed?

    A healthcare provider will complete an evaluation to rule out other potential causes of the symptoms. Two sets of criteria, from the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, and the International Classification of Disease (ICD), published by the World Health Organization. may be used to diagnose schizophrenia.

    What are the DSM-5 criteria for schizophrenia?

    What are the ICD-11 criteria for schizophrenia?

    What are some of the main medical treatments for schizophrenia?

    Antipsychotic medications are the most effective treatments for schizophrenia. They are usually taken orally, but can be injected intramuscularly in urgent situations. However, these medications are associated with unpleasant side effects such as weight gain, sedation, and extrapyramidal symptoms (uncontrollable involuntary movements).[4]

    Have any supplements been studied for schizophrenia?

    D-serine, sarcosine, and Ginkgo biloba have been shown to be effective at reducing symptoms of schizophrenia when used as adjunctive treatments to antipsychotic medications.

    A meta-analysis of randomized controlled trials found that, when used as an adjunct to antipsychotics, B vitamins, specifically Vitamin B6, Vitamin B12, and Folic Acid, were able to reduce total psychiatric symptoms in people with schizophrenia. However, the results were highly variable, and it was not entirely clear which specific vitamins or amounts determined the effect.[5]

    How could diet affect schizophrenia?

    There is limited evidence that dietary changes might affect schizophrenia. The Dietary Inflammatory Index (DII) is a metric used to assess the inflammatory potential of a dietary pattern. A higher DII score is associated with a more inflammatory diet. A small observational study found that people with schizophrenia are more likely to follow a dietary pattern with a high DII score.[6] Some trials also found that a gluten-free diet reduced symptoms of schizophrenia. However, additional trials failed to find the same result.[7]

    Are there any other treatments for schizophrenia?

    Psychotherapy, specifically cognitive behavioral therapy, is often used with medication. Electroconvulsive therapy may also be beneficial for people with schizophrenia.[4][8]

    What causes schizophrenia?

    There have been numerous proposed hypotheses regarding the cause of schizophrenia. However, the exact cause is unknown. It does appear that genes, environmental factors, and neurotransmitter imbalances may all be involved.[4]

    Examine Database: Schizophrenia

    D-Serine
    Ginkgo Biloba
    Sarcosine
    Inositol
    Resveratrol
    Ashwagandha
    Cannabidiol (CBD)
    Fish Oil
    Folic Acid (Vitamin B9)
    Saffron
    Theanine
    Berberine
    Chromium
    Creatine
    Glycine
    L-Tyrosine
    N-Acetylcysteine
    Panax Ginseng (Korean Ginseng)

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    Frequently asked questions

    What is schizophrenia?

    Schizophrenia is a severe mental illness that interferes with a person’s thinking and perception of the world around them. Even though schizophrenia affects about 1% of the world's population, it is one of the top 20 causes of disability worldwide.[1][2][3]

    Is schizophrenia the same as psychosis?

    No. Psychosis is a general term used to describe the sensation of losing touch with reality. Schizophrenia is a condition that causes psychosis. Psychosis can also be brought on by other mental health disorders like bipolar disorder and schizoaffective disorder, as well as brain diseases like Alzheimer’s Disease and epilepsy.[9]

    What are the main signs and symptoms of schizophrenia?

    Symptoms of schizophrenia are broken down into two main categories:

    • Positive symptoms — experiences that add to existing emotions or thoughts — such as hallucinations, delusions, and disordered thinking.

    • Negative symptoms — experiences that subtract from emotions or thoughts — such as reduced speech, lack of motivation, and decreased emotional expression.

    Catatonia, which is characterized by repetitive non-goal directed movements, unresponsiveness, and episodes of overactivity or immobility, is another common symptom of schizophrenia. Additionally, cognitive impairment, which can affect things like memory, processing speed, and attention, has recently been recognized as a symptom of schizophrenia. Symptoms of schizophrenia usually begin to appear between the ages of 16 and 30.[4][1]

    What’s the difference between positive and negative symptoms?

    Positive symptoms refer to behaviors or emotions that are added to “normal” thought processes. For example, a person with schizophrenia may have hallucinations where they hear voices or see objects that are not perceivable by others.

    Negative symptoms refer to behaviors or emotions that are subtracted from “normal” thought processes. In this situation, a person with schizophrenia may display a "flat affect" or no emotion at all.

    How is schizophrenia diagnosed?

    A healthcare provider will complete an evaluation to rule out other potential causes of the symptoms. Two sets of criteria, from the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, and the International Classification of Disease (ICD), published by the World Health Organization. may be used to diagnose schizophrenia.

    What are the DSM-5 criteria for schizophrenia?

    According to the DSM-5, people must experience two or more of the following symptoms during a 1-month period, with at least one of these being options 1, 2, or 3 (for people with a history of autism spectrum disorder or a communication disorder, 1 or 2 only).

    1. Delusions
    2. Hallucinations
    3. Disorganized speech
    4. Grossly disorganized or catatonic behaviors
    5. Negative symptoms

    There must be a significant level of dysfunction in one or more major areas (relationships, work, or school) that persists for at least 6 months, which must include at least 1 month of symptoms.

    Finally, schizoaffective disorder and depressive or bipolar disorder with psychotic features must be ruled out, and the symptoms must not be attributable to psychoactive substances or medical conditions.

    What are some of the main medical treatments for schizophrenia?

    Antipsychotic medications are the most effective treatments for schizophrenia. They are usually taken orally, but can be injected intramuscularly in urgent situations. However, these medications are associated with unpleasant side effects such as weight gain, sedation, and extrapyramidal symptoms (uncontrollable involuntary movements).[4]

    Have any supplements been studied for schizophrenia?

    D-serine, sarcosine, and Ginkgo biloba have been shown to be effective at reducing symptoms of schizophrenia when used as adjunctive treatments to antipsychotic medications.

    A meta-analysis of randomized controlled trials found that, when used as an adjunct to antipsychotics, B vitamins, specifically Vitamin B6, Vitamin B12, and Folic Acid, were able to reduce total psychiatric symptoms in people with schizophrenia. However, the results were highly variable, and it was not entirely clear which specific vitamins or amounts determined the effect.[5]

    How could diet affect schizophrenia?

    There is limited evidence that dietary changes might affect schizophrenia. The Dietary Inflammatory Index (DII) is a metric used to assess the inflammatory potential of a dietary pattern. A higher DII score is associated with a more inflammatory diet. A small observational study found that people with schizophrenia are more likely to follow a dietary pattern with a high DII score.[6] Some trials also found that a gluten-free diet reduced symptoms of schizophrenia. However, additional trials failed to find the same result.[7]

    Are there any other treatments for schizophrenia?

    Psychotherapy, specifically cognitive behavioral therapy, is often used with medication. Electroconvulsive therapy may also be beneficial for people with schizophrenia.[4][8]

    What causes schizophrenia?

    There have been numerous proposed hypotheses regarding the cause of schizophrenia. However, the exact cause is unknown. It does appear that genes, environmental factors, and neurotransmitter imbalances may all be involved.[4]

    References

    1. ^Schizophrenia: MedlinePlus; Bethesda, MD: National Library of Medicine US, cited October 26, 2022
    2. ^Marder SR, Cannon TDSchizophrenia.N Engl J Med.(2019-10-31)
    3. ^GBD 2016 Disease and Injury Incidence and Prevalence CollaboratorsGlobal, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016Lancet.(2017 Sep 16)
    4. ^Jauhar S, Johnstone M, McKenna PJSchizophrenia.Lancet.(2022-01-29)
    5. ^Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, Yung ARThe effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis.Psychol Med.(2017-Jul)
    6. ^Jahrami H, Faris MA, Ghazzawi HA, Saif Z, Habib L, Shivappa N, Hébert JRIncreased Dietary Inflammatory Index Is Associated with Schizophrenia: Results of a Case-Control Study from Bahrain.Nutrients.(2019-Aug-11)
    7. ^Onaolapo OJ, Onaolapo AYNutrition, nutritional deficiencies, and schizophrenia: An association worthy of constant reassessment.World J Clin Cases.(2021-Oct-06)
    8. ^Ali SA, Mathur N, Malhotra AK, Braga RJElectroconvulsive Therapy and Schizophrenia: A Systematic Review.Mol Neuropsychiatry.(2019-Apr)
    9. ^Arciniegas DBPsychosis.Continuum (Minneap Minn).(2015-Jun)
    10. ^International Classification of Diseases, Eleventh Revision (ICD-11), World Health Organization (WHO); licensed under Creative Commons Attribution-NoDerivatives 3.0 IGO license (CC BY-ND 3.0 IGO); cited October 26, 2022;.

    Examine Database References

    1. Schizophrenia symptoms - Zhang XY, Zhou DF, Zhang PY, Wu GY, Su JM, Cao LYA double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophreniaJ Clin Psychiatry.(2001 Nov)
    2. Schizophrenia symptoms - Doruk A, Uzun O, Ozşahin AA placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophreniaInt Clin Psychopharmacol.(2008 Jul)
    3. Schizophrenia symptoms - Atmaca M, Tezcan E, Kuloglu M, Ustundag B, Kirtas OThe effect of extract of ginkgo biloba addition to olanzapine on therapeutic effect and antioxidant enzyme levels in patients with schizophreniaPsychiatry Clin Neurosci.(2005 Dec)
    4. Serum BDNF - Zhang XY, Zhang WF, Zhou DF, Chen da C, Xiu MH, Wu HR, Haile CN, Kosten TA, Kosten TRBrain-derived neurotrophic factor levels and its Val66Met gene polymorphism predict tardive dyskinesia treatment response to Ginkgo bilobaBiol Psychiatry.(2012 Oct 15)
    5. Schizophrenia symptoms - Eric Y H Chen, Christy L M HuiHT1001, a proprietary North American ginseng extract, improves working memory in schizophrenia: a double-blind, placebo-controlled studyPhytother Res.(2012 Aug)
    6. Schizophrenia symptoms - McGuire P, Robson P, Cubala WJ, Vasile D, Morrison PD, Barron R, Taylor A, Wright SCannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled TrialAm J Psychiatry.(2018 Mar 1)
    7. Schizophrenia symptoms - Boggs DL, Surti T, Gupta A, Gupta S, Niciu M, Pittman B, Schnakenberg Martin AM, Thurnauer H, Davies A, D'Souza DC, Ranganathan MThe effects of cannabidiol (CBD) on cognition and symptoms in outpatients with chronic schizophrenia a randomized placebo controlled trialPsychopharmacology (Berl).(2018 Jul)
    8. Schizophrenia symptoms - Godfrey PS, Toone BK, Carney MW, Flynn TG, Bottiglieri T, Laundy M, Chanarin I, Reynolds EHEnhancement of recovery from psychiatric illness by methylfolateLancet.(1990 Aug 18)
    9. Schizophrenia symptoms - Sakuma K, Matsunaga S, Nomura I, Okuya M, Kishi T, Iwata NFolic acid/methylfolate for the treatment of psychopathology in schizophrenia: a systematic review and meta-analysis.Psychopharmacology (Berl).(2018-Aug)
    10. Schizophrenia symptoms - Kantrowitz JT, Malhotra AK, Cornblatt B, Silipo G, Balla A, Suckow RF, D'Souza C, Saksa J, Woods SW, Javitt DCHigh dose D-serine in the treatment of schizophreniaSchizophr Res.(2010 Aug)
    11. Schizophrenia symptoms - Tsai G, Yang P, Chung LC, Lange N, Coyle JTD-serine added to antipsychotics for the treatment of schizophreniaBiol Psychiatry.(1998 Dec 1)
    12. Schizophrenia symptoms - Lane HY, Lin CH, Huang YJ, Liao CH, Chang YC, Tsai GEA randomized, double-blind, placebo-controlled comparison study of sarcosine (N-methylglycine) and D-serine add-on treatment for schizophreniaInt J Neuropsychopharmacol.(2010 May)
    13. Schizophrenia symptoms - Lane HY, Chang YC, Liu YC, Chiu CC, Tsai GESarcosine or D-serine add-on treatment for acute exacerbation of schizophrenia: a randomized, double-blind, placebo-controlled studyArch Gen Psychiatry.(2005 Nov)
    14. Schizophrenia symptoms - Weiser M, Heresco-Levy U, Davidson M, Javitt DC, Werbeloff N, Gershon AA, Abramovich Y, Amital D, Doron A, Konas S, Levkovitz Y, Liba D, Teitelbaum A, Mashiach M, Zimmerman YA multicenter, add-on randomized controlled trial of low-dose d-serine for negative and cognitive symptoms of schizophreniaJ Clin Psychiatry.(2012 Jun)
    15. Schizophrenia symptoms - Heresco-Levy U, Javitt DC, Ebstein R, Vass A, Lichtenberg P, Bar G, Catinari S, Ermilov MD-serine efficacy as add-on pharmacotherapy to risperidone and olanzapine for treatment-refractory schizophreniaBiol Psychiatry.(2005 Mar 15)
    16. Schizophrenia symptoms - Chengappa KNR, Brar JS, Gannon JM, Schlicht PJAdjunctive Use of a Standardized Extract of Withania somnifera (Ashwagandha) to Treat Symptom Exacerbation in Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled StudyJ Clin Psychiatry.(2018 Jul 10)
    17. High-density lipoprotein (HDL) - Agnihotri AP, Sontakke SD, Thawani VR, Saoji A, Goswami VSEffects of Withania somnifera in patients of schizophrenia: A randomized, double blind, placebo controlled pilot trial studyIndian J Pharmacol.(2013 Jul)
    18. Schizophrenia symptoms - Lane HY, Huang CL, Wu PL, Liu YC, Chang YC, Lin PY, Chen PW, Tsai GGlycine transporter I inhibitor, N-methylglycine (sarcosine), added to clozapine for the treatment of schizophreniaBiol Psychiatry.(2006 Sep 15)
    19. Schizophrenia symptoms - Tsai G, Lane HY, Yang P, Chong MY, Lange NGlycine transporter I inhibitor, N-methylglycine (sarcosine), added to antipsychotics for the treatment of schizophreniaBiol Psychiatry.(2004 Mar 1)
    20. Schizophrenia symptoms - Levine J, Goldberger I, Rapaport A, Schwartz M, Schield C, Elizur A, Belmaker RH, Shapiro J, Agam GCSF inositol in schizophrenia and high-dose inositol treatment of schizophreniaEur Neuropsychopharmacol.(1994 Dec)
    21. Schizophrenia symptoms - Levine J, Umansky R, Ezrielev G, Belmaker RHLack of effect of inositol treatment in chronic schizophreniaBiol Psychiatry.(1993 Apr 15-May 1)
    22. Schizophrenia symptoms - Joseph Levine, Mirtha Gonsalves, Izak Babur, Shaul Stier, Avner Elizur, Ora Kofman, R. H. BelmakerInositol 6 g daily may be effective in depression but not in schizophreniaHuman Psychopharmacology: Clinical and Experimental.()
    23. Schizophrenia symptoms - Kaptsan A, Odessky A, Osher Y, Levine JLack of efficacy of 5 grams daily of creatine in schizophrenia: a randomized, double-blind, placebo-controlled trialJ Clin Psychiatry.(2007 Jun)
    24. Schizophrenia symptoms - Deutsch SI, Rosse RB, Schwartz BL, Banay-Schwartz M, McCarthy MF, Johri SKL-tyrosine pharmacotherapy of schizophrenia: preliminary dataClin Neuropharmacol.(1994 Feb)
    25. Schizophrenia symptoms - Ritsner MS, Miodownik C, Ratner Y, Shleifer T, Mar M, Pintov L, Lerner VL-theanine relieves positive, activation, and anxiety symptoms in patients with schizophrenia and schizoaffective disorder: an 8-week, randomized, double-blind, placebo-controlled, 2-center studyJ Clin Psychiatry.(2011 Jan)
    26. Cortisol - Chanoch Miodownik, Rachel Maayan, Yael Ratner, Vladimir Lerner, Leonid Pintov, Maria Mar, Abraham Weizman, Michael S RitsnerSerum levels of brain-derived neurotrophic factor and cortisol to sulfate of dehydroepiandrosterone molar ratio associated with clinical response to L-theanine as augmentation of antipsychotic therapy in schizophrenia and schizoaffective disorder patientsClin Neuropharmacol.(Jul-Aug 2011)
    27. Schizophrenia symptoms - Heresco-Levy U, Ermilov M, Lichtenberg P, Bar G, Javitt DCHigh-dose glycine added to olanzapine and risperidone for the treatment of schizophreniaBiol Psychiatry.(2004 Jan 15)
    28. Schizophrenia symptoms - Hockney RA, Montgomery P, Williams C, Geddes JR, Cowen PJLack of effect of chromium supplementation on mental state and body weight in people with schizophreniaJ Clin Psychopharmacol.(2006 Oct)
    29. Schizophrenia symptoms - Yolland CO, Hanratty D, Neill E, Rossell SL, Berk M, Dean OM, Castle DJ, Tan EJ, Phillipou A, Harris AW, Barreiros AR, Hansen A, Siskind DMeta-analysis of randomised controlled trials with -acetylcysteine in the treatment of schizophrenia.Aust N Z J Psychiatry.(2020-May)
    30. Schizophrenia symptoms - Montazer M, Ebrahimpour-Koujan S, Surkan PJ, Azadbakht LEffects of Fish-Oil Consumption on Psychological Function Outcomes in Psychosis: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.Adv Nutr.(2022-Dec-22)
    31. Oxidative Stress Biomarkers - T Pawełczyk, M Grancow-Grabka, E Trafalska, J Szemraj, A PawełczykOxidative stress reduction related to the efficacy of n-3 polyunsaturated fatty acids in first episode schizophrenia: Secondary outcome analysis of the OFFER randomized trialProstaglandins Leukot Essent Fatty Acids.(2017 Jun)
    32. Interleukin 6 - Asbaghi O, Sadeghian M, Sadeghi O, Rigi S, Tan SC, Shokri A, Mousavi SMEffects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: A systematic review and meta-analysis.Phytother Res.(2021-Jan)
    33. C-Reactive Protein (CRP) - Bentolhoda Mousavi, Seyedeh Zahra Bathaie, Farbod Fadai, Zabihollah Ashtari, Neda Ali Beigi, Sara Farhang, Sara Hashempour, Nasim Shahhamzei, Hamid HeidarzadehSafety evaluation of saffron stigma (Crocus sativus L.) aqueous extract and crocin in patients with schizophreniaAvicenna J Phytomed.(Sep-Oct 2015)
    34. Blood Pressure - Guo XF, Li JM, Tang J, Li DEffects of resveratrol supplementation on risk factors of non-communicable diseases: A meta-analysis of randomized controlled trials.Crit Rev Food Sci Nutr.(2018)
    35. Weight - Mousavi SM, Milajerdi A, Sheikhi A, Kord-Varkaneh H, Feinle-Bisset C, Larijani B, Esmaillzadeh AResveratrol supplementation significantly influences obesity measures: a systematic review and dose-response meta-analysis of randomized controlled trials.Obes Rev.(2019-Mar)
    36. Memory - Marx W, Kelly JT, Marshall S, Cutajar J, Annois B, Pipingas A, Tierney A, Itsiopoulos CEffect of resveratrol supplementation on cognitive performance and mood in adults: a systematic literature review and meta-analysis of randomized controlled trials.Nutr Rev.(2018-Jun-01)
    37. Total cholesterol - Blais JE, Huang X, Zhao JVOverall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.Drugs.(2023-Apr)