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| Boilerpipe Text | Key Takeaways
Schizophrenia is a mental disorder that can start with subtle signs like social withdrawal and strange behavior.
Early symptoms of schizophrenia can look like other mental health conditions, making it hard to diagnose.
Recognizing early warning signs and getting help from a healthcare provider is important for managing schizophrenia.
Schizophrenia
is a chronic psychiatric disorder that affects how a person thinks, feels, and behaves. Common early signs of schizophrenia vary by age group and include:
Young children:Â
Delayed development
Older kids and teens:
 Depression, isolation, behavioral problems (e.g., stealing) or changes (e.g., bizarre or unusual thoughts or actions), and trouble focusing
Adults:Â
Restlessness, anxiety, low energy, not taking care of oneself (e.g., personal hygiene), decrease in work performance, suicidal thoughts, and social withdrawal
It is estimated that schizophrenia affects less than 1% of adults worldwide.
Schizophrenia usually develops slowly, with early warning signs starting before the first severe episode. Knowing these warning signs can help a healthcare provider diagnose schizophrenia sooner and make sure that a person living with the condition gets the care and support that they need.
Westend61 / Getty images
Early Warning Signs of Schizophrenia
The time during which the early warning signs of schizophrenia are experienced is called the
prodromal stage
. The onset of schizophrenia can last from months to years. The first signs of schizophrenia can be different depending on how old a person is when the disorder develops.Â
The age at which someone develops schizophrenia is thought to influence the symptoms they will have.
Even though men and women have roughly similar rates of schizophrenia, they tend to develop the condition at slightly different ages.
Positive Signs
Positive symptoms can be the first signs of schizophrenia. In mental health terms, "positive" means these symptoms are present, not that they are beneficial.
For instance, someone with schizophrenia may experience hallucinations, while someone without the condition would not.
Early positive symptoms might worsen before a severe episode of
psychosis
. These warning signs include:
Confusing speech
Strange and/or intense thoughts and feelings
New difficulty thinking clearly or concentrating
Suspiciousness of or uneasiness with others (paranoia)
Trouble telling reality from fantasy, seeing and/or hearing things that are not there (delusions/hallucinations)
These early warning signs might continue and could worsen, especially without diagnosis and treatment.
Negative Signs
Negative symptoms of schizophrenia tend to develop later. "Negative" means these traits are absent or reduced.
People with schizophrenia often show fewer typical behaviors, such as the ability to feel pleasure or engage in conversation.
Examples of negative symptoms include:
Limited talking or no talking
Having no feelings (flat affect)
Spending a lot more time alone than usual (withdrawing socially)
Lack of initiative (for example, not completing tasks at home, work, or school)
Decline in self-care or personal hygiene
Being unable to feel pleasure
Schizophrenia Warning Signs by Age
Schizophrenia can vary from person to person, as individuals may not experience all positive or negative symptoms. The condition can also present differently based on the age when it develops.
In Young Children
People who are diagnosed withÂ
schizophrenia in childhood
 have more developmental delays than people who are diagnosed later in life.Â
Very early developmental warning signs of schizophrenia include:
Delayed motor development
(such as not walking until over 18 months old)
Delayed speech and/or language development
(such as not speaking meaningful two- or three-word phrases until over 36 months old)
Impaired social development at an early age
(such as not using gestures to communicate or failing to regulate facial expressions)
It is important to note that these delays are not always a sign of schizophrenia. There are also other reasons a child may have delays, so itâs important to have them evaluated by their provider.Â
In Teenagers
Before the onset of schizophrenia, adolescents often develop changes in behavior. They are likely to end up struggling in schoolâone of the most common issues reported in teens diagnosed with schizophrenia.Â
Early warning signs of schizophrenia in teens include:
Difficulty concentrating and paying attention
Unexplained functional decline
Increased introversion
Loneliness
Depression
Aggression
Suicidal ideation
Theft
Bizarre behaviors
It is hard to diagnose schizophrenia in adolescents because many of the features of the condition are also common during normal childhood development. For example, a normal part of childhood is having vivid imaginations and fantasies. However, these can be misunderstood to be hallucinationsâa symptom of schizophrenia.
It is thought that children might be less likely to have paranoid delusions (the belief that others are out to harm them) than people who develop schizophrenia at an older age.
Ellen Lindner / Verywell
In Early Adulthood
Schizophrenia typically develops during early adulthood. Its onset is characterized by changes in behavior and a deterioration in functioning in daily life.Â
The most common early warning signs of schizophrenia include:
Nervousness and/or restlessness
Depression
Anxiety
Difficulty in thinking clearly or concentrating
Worrying
Lack of self-confidence
Lack of energy and/or slowness
A worrying drop in grades or job performance
Social withdrawal and/or uneasiness around other people
What Are Prodromal Symptoms in Schizophrenia?
Some, but not all, people with schizophrenia experience a prodromal stage before the full-blown disorder happens. The prodromal symptoms of schizophrenia can be somewhat nonspecific and include feeling nervous, anxious, depressed, and having trouble concentrating. It can be hard to tell that these symptoms will ultimately be related to schizophrenia since they are also common in other mental and physical health disorders.
Not everyone will experience these early warning signs at the same time in their lives. According to some studies, these prodromal symptoms can be present for years.
Over the Age of 45
Most early warning signs of schizophrenia for people over the age of 45 are the same as those for people who develop schizophrenia at a younger age.
Some scientists think that people who develop schizophrenia later in life will have fewer disorganized thinking and negative symptoms than people who develop it earlier.
In the past, studies suggested that people who develop schizophrenia later in life may not have the same symptoms as people diagnosed earlier. However, more recent research suggests that the key features of schizophreniaâlike negative symptomsâare often similar for people who are diagnosed at an older age compared to those who are diagnosed younger.
When Schizophrenia Symptoms Start
Symptoms usually start to develop in early adulthood, between late adolescence and the early 30s. The disorder typically becomes evident slightly earlier in men than it does in women. The symptoms of schizophrenia often show up between late adolescence and the early 20s in men and between the early 20s and the early 30s in women.
Early Onset Schizophrenia
When the disorder is diagnosed before the age of 18, it is referred to as early onset schizophrenia (EOS). EOS is rare, with an estimated prevalence of 0.23%.
Even more rarely, schizophrenia can develop in very young children. This is called childhood-onset schizophrenia (COS) and it is diagnosed before the age of 13.
According to the National Institute of Mental Health, approximately one in 40,000 children will have COS.
It is thought to be extremely uncommon that COS will develop before the age of 10.Â
Late-Onset Schizophrenia
Although schizophrenia most commonly starts between late adolescence and the early 30s, it is estimated that up to 20% of patients first have symptoms after the age of 40 years old.
Some scientists have identified this as a subtype of schizophrenia called late-onset schizophrenia (LOS).
Women are more likely to be in this group than men. The symptoms typically develop inÂ
menopause
, between ages 44 and 49 years old. However, it is still more common for schizophrenia to develop in early adulthood than at this time in life.Â
Causes and Risk Factors
Since a lot of the early signs of schizophrenia can also be caused by other conditions (like depression and anxiety), itâs important to understand why some people develop schizophrenia.Â
While the exact
cause
of schizophrenia is not known, there are a few risk factors that researchers think make a person more likely to develop it.
Schizophrenia has a strong genetic component and is highly heritable. Having a family member with schizophrenia increases your risk of developing the disease.Â
These risk factors will be taken into account regarding a
diagnosis
if you are thought to be experiencing these early warning signs of schizophrenia.
For example, genetics, brain structure and function, and the environment a person grew up in (e.g., exposure to poverty, stress, viruses, and nutritional deficiencies) can all influence whether a person will be diagnosed with schizophrenia in their lifetime.
Complications
In the early stages of schizophrenia, the disorder can be confused with other common mental health conditions, like depression. It can be hard even for providers to tell them apart since most common early warning signs for schizophrenia are also among the most common initial symptoms for moderate to severe depression.
It is not until the positive symptoms (such as hallucinations, delusions, and disorganized thoughts and speech) of schizophrenia show up that it gets easier to tell apart from other mental health conditions.
Getting the correct diagnosis and connecting people with support and treatment is crucial to keep them safe and help them manage life with the condition.Â
People are at risk for suicidal thoughts and may act on those thoughts. The risk of suicide for people living with schizophrenia is higher for men and people who were diagnosed at a young age.
Depression has been identified as a major risk factor for suicide among people living with schizophrenia. Having other mental health concerns, like substance use disorder, also increases the risk of suicide among people living with schizophrenia.
If you or your loved one is thinking of or talking about harming themselves, contact someone who can help right away. You can call the toll-free, 24-hour
National Suicide Prevention Lifeline (Lifeline)
at 800-237-8255.
If you require immediate emergency care, call 911 for emergency services or go to the nearest hospital emergency room.
When to See a Healthcare Provider
Schizophrenia usually develops gradually, so it can be hard to pinpoint when changes in behavior start or whether they are something to worry about. In general, if you recognize that youâre having a pattern of concerning behaviors, take it as a sign that you need to talk to a provider about what youâre going through.Â
If you are aware of the warning signs of schizophrenia at each age, you may be more likely to spot them early. While these changes might not be concerning by themselves, if you or a loved one are having several of them, talk to a mental health professional. Keep in mind that it can be difficult for people to get helpâespecially if they are experiencing symptoms such asÂ
paranoia
. | |||||||||
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Schizophrenia Guide
Schizophrenia Guide
- [Overview](https://www.verywellhealth.com/schizophrenia-8597724)
- [Types](https://www.verywellhealth.com/types-of-schizophrenia-5094170)
- [Early Signs](https://www.verywellhealth.com/early-signs-schizophrenia-5101519)
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- [Diagnosis](https://www.verywellhealth.com/schizophrenia-diagnosis-8550221)
# Early Signs and Symptoms of Schizophrenia
By [Ruth Edwards](https://www.verywellhealth.com/ruth-edwards-5086015)
Updated on March 22, 2026
Medically reviewed by [Geralyn Dexter, PhD, LMHC](https://www.verywellhealth.com/geralyn-dexter-5193744)
Table of Contents
View All
Table of Contents
- [Early Warning Signs](https://www.verywellhealth.com/early-signs-schizophrenia-5101519#toc-early-warning-signs-of-schizophrenia)
- [Signs by Age](https://www.verywellhealth.com/early-signs-schizophrenia-5101519#toc-schizophrenia-warning-signs-by-age)
- [When Symptoms Start](https://www.verywellhealth.com/early-signs-schizophrenia-5101519#toc-when-schizophrenia-symptoms-start)
- [Causes and Risk Factors](https://www.verywellhealth.com/early-signs-schizophrenia-5101519#toc-causes-and-risk-factors)
- [Complications](https://www.verywellhealth.com/early-signs-schizophrenia-5101519#toc-complications)
- [When to See a Provider](https://www.verywellhealth.com/early-signs-schizophrenia-5101519#toc-when-to-see-a-healthcare-provider)
- Next in Schizophrenia Guide
[Positive and Negative Schizophrenia Symptoms](https://www.verywellhealth.com/schizophrenia-symptoms-8551091)
### Key Takeaways
- Schizophrenia is a mental disorder that can start with subtle signs like social withdrawal and strange behavior.
- Early symptoms of schizophrenia can look like other mental health conditions, making it hard to diagnose.
- Recognizing early warning signs and getting help from a healthcare provider is important for managing schizophrenia.
[Schizophrenia](https://www.verywellhealth.com/schizophrenia-8597724) is a chronic psychiatric disorder that affects how a person thinks, feels, and behaves. Common early signs of schizophrenia vary by age group and include:
- **Young children:** Delayed development
- **Older kids and teens:** Depression, isolation, behavioral problems (e.g., stealing) or changes (e.g., bizarre or unusual thoughts or actions), and trouble focusing
- **Adults:** Restlessness, anxiety, low energy, not taking care of oneself (e.g., personal hygiene), decrease in work performance, suicidal thoughts, and social withdrawal
It is estimated that schizophrenia affects less than 1% of adults worldwide.
Schizophrenia usually develops slowly, with early warning signs starting before the first severe episode. Knowing these warning signs can help a healthcare provider diagnose schizophrenia sooner and make sure that a person living with the condition gets the care and support that they need.
![Double exposure of man's profile - stock photo]()
:max_bytes\(150000\):strip_icc\(\)/GettyImages-900247162-6a31fd6faed94e88a6d140db4d647f78.jpg)
Westend61 / Getty images
## Early Warning Signs of Schizophrenia
The time during which the early warning signs of schizophrenia are experienced is called the [prodromal stage](https://www.verywellhealth.com/prodromal-schizophrenia-5194244). The onset of schizophrenia can last from months to years. The first signs of schizophrenia can be different depending on how old a person is when the disorder develops.
The age at which someone develops schizophrenia is thought to influence the symptoms they will have. Even though men and women have roughly similar rates of schizophrenia, they tend to develop the condition at slightly different ages.
### Positive Signs
Positive symptoms can be the first signs of schizophrenia. In mental health terms, "positive" means these symptoms are present, not that they are beneficial.
For instance, someone with schizophrenia may experience hallucinations, while someone without the condition would not.
Early positive symptoms might worsen before a severe episode of [psychosis](https://www.verywellhealth.com/psychosis-vs-schizophrenia-5095195). These warning signs include:
- Confusing speech
- Strange and/or intense thoughts and feelings
- New difficulty thinking clearly or concentrating
- Suspiciousness of or uneasiness with others (paranoia)
- Trouble telling reality from fantasy, seeing and/or hearing things that are not there (delusions/hallucinations)
These early warning signs might continue and could worsen, especially without diagnosis and treatment.
### Negative Signs
Negative symptoms of schizophrenia tend to develop later. "Negative" means these traits are absent or reduced.
People with schizophrenia often show fewer typical behaviors, such as the ability to feel pleasure or engage in conversation.
Examples of negative symptoms include:
- Limited talking or no talking
- Having no feelings (flat affect)
- Spending a lot more time alone than usual (withdrawing socially)
- Lack of initiative (for example, not completing tasks at home, work, or school)
- Decline in self-care or personal hygiene
- Being unable to feel pleasure
## Schizophrenia Warning Signs by Age
Schizophrenia can vary from person to person, as individuals may not experience all positive or negative symptoms. The condition can also present differently based on the age when it develops.
### In Young Children
People who are diagnosed with [schizophrenia in childhood](https://www.verywellhealth.com/disorganized-schizophrenia-5097138) have more developmental delays than people who are diagnosed later in life.
Very early developmental warning signs of schizophrenia include:
- **Delayed motor development** (such as not walking until over 18 months old)
- **Delayed speech and/or language development** (such as not speaking meaningful two- or three-word phrases until over 36 months old)
- **Impaired social development at an early age** (such as not using gestures to communicate or failing to regulate facial expressions)
It is important to note that these delays are not always a sign of schizophrenia. There are also other reasons a child may have delays, so itâs important to have them evaluated by their provider.
### In Teenagers
Before the onset of schizophrenia, adolescents often develop changes in behavior. They are likely to end up struggling in schoolâone of the most common issues reported in teens diagnosed with schizophrenia.
Early warning signs of schizophrenia in teens include:
- Difficulty concentrating and paying attention
- Unexplained functional decline
- Increased introversion
- Loneliness
- [Depression](https://www.verywellhealth.com/clinical-depression-7643137)
- Aggression
- Suicidal ideation
- Theft
- Bizarre behaviors
It is hard to diagnose schizophrenia in adolescents because many of the features of the condition are also common during normal childhood development. For example, a normal part of childhood is having vivid imaginations and fantasies. However, these can be misunderstood to be hallucinationsâa symptom of schizophrenia.
It is thought that children might be less likely to have paranoid delusions (the belief that others are out to harm them) than people who develop schizophrenia at an older age.
![Early Signs of Schizophrenia in Young Adulthood]()
:max_bytes\(150000\):strip_icc\(\)/early-signs-schizophrenia-5101519_final-6861147c5e4e4a09956011952057ba72.jpg)
Ellen Lindner / Verywell
### In Early Adulthood
Schizophrenia typically develops during early adulthood. Its onset is characterized by changes in behavior and a deterioration in functioning in daily life.
The most common early warning signs of schizophrenia include:
- Nervousness and/or restlessness
- Depression
- [Anxiety](https://www.verywellhealth.com/anxiety-attack-5088600)
- Difficulty in thinking clearly or concentrating
- Worrying
- Lack of self-confidence
- Lack of energy and/or slowness
- A worrying drop in grades or job performance
- Social withdrawal and/or uneasiness around other people
### What Are Prodromal Symptoms in Schizophrenia?
Some, but not all, people with schizophrenia experience a prodromal stage before the full-blown disorder happens. The prodromal symptoms of schizophrenia can be somewhat nonspecific and include feeling nervous, anxious, depressed, and having trouble concentrating. It can be hard to tell that these symptoms will ultimately be related to schizophrenia since they are also common in other mental and physical health disorders.
Not everyone will experience these early warning signs at the same time in their lives. According to some studies, these prodromal symptoms can be present for years.
### Over the Age of 45
Most early warning signs of schizophrenia for people over the age of 45 are the same as those for people who develop schizophrenia at a younger age.
Some scientists think that people who develop schizophrenia later in life will have fewer disorganized thinking and negative symptoms than people who develop it earlier.
In the past, studies suggested that people who develop schizophrenia later in life may not have the same symptoms as people diagnosed earlier. However, more recent research suggests that the key features of schizophreniaâlike negative symptomsâare often similar for people who are diagnosed at an older age compared to those who are diagnosed younger.
## When Schizophrenia Symptoms Start
Symptoms usually start to develop in early adulthood, between late adolescence and the early 30s. The disorder typically becomes evident slightly earlier in men than it does in women. The symptoms of schizophrenia often show up between late adolescence and the early 20s in men and between the early 20s and the early 30s in women.
### Early Onset Schizophrenia
When the disorder is diagnosed before the age of 18, it is referred to as early onset schizophrenia (EOS). EOS is rare, with an estimated prevalence of 0.23%. Even more rarely, schizophrenia can develop in very young children. This is called childhood-onset schizophrenia (COS) and it is diagnosed before the age of 13.
According to the National Institute of Mental Health, approximately one in 40,000 children will have COS. It is thought to be extremely uncommon that COS will develop before the age of 10.
### Late-Onset Schizophrenia
Although schizophrenia most commonly starts between late adolescence and the early 30s, it is estimated that up to 20% of patients first have symptoms after the age of 40 years old. Some scientists have identified this as a subtype of schizophrenia called late-onset schizophrenia (LOS).
Women are more likely to be in this group than men. The symptoms typically develop in [menopause](https://www.verywellhealth.com/menopause-4014690), between ages 44 and 49 years old. However, it is still more common for schizophrenia to develop in early adulthood than at this time in life.
## Causes and Risk Factors
Since a lot of the early signs of schizophrenia can also be caused by other conditions (like depression and anxiety), itâs important to understand why some people develop schizophrenia.
While the exact [cause](https://www.verywellhealth.com/disorganized-schizophrenia-5097138) of schizophrenia is not known, there are a few risk factors that researchers think make a person more likely to develop it.
Schizophrenia has a strong genetic component and is highly heritable. Having a family member with schizophrenia increases your risk of developing the disease.
These risk factors will be taken into account regarding a [diagnosis](https://www.verywellhealth.com/schizophrenia-diagnosis-8550221) if you are thought to be experiencing these early warning signs of schizophrenia.
For example, genetics, brain structure and function, and the environment a person grew up in (e.g., exposure to poverty, stress, viruses, and nutritional deficiencies) can all influence whether a person will be diagnosed with schizophrenia in their lifetime.
## Complications
In the early stages of schizophrenia, the disorder can be confused with other common mental health conditions, like depression. It can be hard even for providers to tell them apart since most common early warning signs for schizophrenia are also among the most common initial symptoms for moderate to severe depression.
It is not until the positive symptoms (such as hallucinations, delusions, and disorganized thoughts and speech) of schizophrenia show up that it gets easier to tell apart from other mental health conditions.
Getting the correct diagnosis and connecting people with support and treatment is crucial to keep them safe and help them manage life with the condition.
People are at risk for suicidal thoughts and may act on those thoughts. The risk of suicide for people living with schizophrenia is higher for men and people who were diagnosed at a young age.
Depression has been identified as a major risk factor for suicide among people living with schizophrenia. Having other mental health concerns, like substance use disorder, also increases the risk of suicide among people living with schizophrenia.
If you or your loved one is thinking of or talking about harming themselves, contact someone who can help right away. You can call the toll-free, 24-hour [National Suicide Prevention Lifeline (Lifeline)](https://suicidepreventionlifeline.org/) at 800-237-8255.
If you require immediate emergency care, call 911 for emergency services or go to the nearest hospital emergency room.
## When to See a Healthcare Provider
Schizophrenia usually develops gradually, so it can be hard to pinpoint when changes in behavior start or whether they are something to worry about. In general, if you recognize that youâre having a pattern of concerning behaviors, take it as a sign that you need to talk to a provider about what youâre going through.
If you are aware of the warning signs of schizophrenia at each age, you may be more likely to spot them early. While these changes might not be concerning by themselves, if you or a loved one are having several of them, talk to a mental health professional. Keep in mind that it can be difficult for people to get helpâespecially if they are experiencing symptoms such as [paranoia](https://www.verywellhealth.com/paranoid-delusions-5095908).
Read more:
- [Health A-Z](https://www.verywellhealth.com/health-a-z-4014770)
- [Mental Health](https://www.verywellhealth.com/mental-health-5079153)
- [Psychotic Disorders](https://www.verywellhealth.com/psychotic-disorders-5205105)
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](https://www.verywellhealth.com/verywell-editorial-process-4777042) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
1. World Health Organization. [Schizophrenia](https://www.who.int/news-room/fact-sheets/detail/schizophrenia).
2. Catts SV, O'Toole BI. [The treatment of schizophrenia: Can we raise the standard of care?](https://doi.org/10.1177/0004867416672725) *Aust N Z J Psychiatry*. 2016;50(12):1128-1138. doi:10.1177/0004867416672725
3. Coulon N, Godin O, Bulzacka E, et al. [Early and very earlyâonset schizophrenia compared with adultâonset schizophrenia: French FACEâSZ database.](https://doi.org/10.1002/brb3.1495) *Brain Behav*. 2020;10(2). doi:10.1002/brb3.1495
4. Ruiz-CastaĂąeda P, Santiago Molina E, Aguirre Loaiza H, Daza GonzĂĄlez MT. [Positive symptoms of schizophrenia and their relationship with cognitive and emotional executive functions](https://doi.org/10.1186%2Fs41235-022-00428-z). *Cogn Res Princ Implic*. 2022;7(1):78. doi:10.1186/s41235-022-00428-z
5. National Institute of Mental Health. [Understanding psychosis](https://www.nimh.nih.gov/health/publications/understanding-psychosis).
6. American Psychiatric Association. [What is schizophrenia?](https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia).
7. Patel KR, Cherian J, Gohil K, Atkinson D. [Schizophrenia: overview and treatment options](https://pmc.ncbi.nlm.nih.gov/articles/PMC4159061/). *P T*. 2014;39(9):638-645.
8. Parellada M, Gomez-Vallejo S, Burdeus M, Arango C. [Developmental differences between schizophrenia and bipolar disorder](https://doi.org/10.1093/schbul/sbx126). *Schizophr Bull*. 2017;43(6):1176-1189. doi:10.1093/schbul/sbx126
9. Bartlett J. [Childhood-onset schizophrenia: what do we really know?](https://doi.org/10.1080/21642850.2014.927738). *Health Psychol Behav Med*. 2014;2(1):735-747. doi:10.1080/21642850.2014.927738
10. McClellan J, Stock S; American Academy of Child and Adolescent Psychiatry Committee on Quality Issues. [Practice parameter for the assessment and treatment of children and adolescents with schizophrenia](https://doi.org/10.1016/j.jaac.2013.02.008). *J Am Acad Child Adolesc Psychiatry*. 2013;52(9):976-990. doi:10.1016/j.jaac.2013.02.008
11. Häfner H. [From onset and prodromal stage to a life-long course of schizophrenia and its symptom dimensions: how sex, age, and other risk factors influence incidence and course of illness](https://doi.org/10.1155/2019/9804836). *Psychiatry J*. 2019;2019:9804836. doi:10.1155/2019/9804836
12. Häfner H. [The concept of schizophrenia: from unity to diversity](https://doi.org/10.1155/2014/929434). *Adv Psychiatry*. 2014;2014. doi:10.1155/2014/929434
13. George M, Maheshwari S, Chandran S, Manohar JS, Sathyanarayana Rao TS. [Understanding the schizophrenia prodrome](https://journals.lww.com/indianjpsychiatry/fulltext/2017/59040/understanding_the_schizophrenia_prodrome.19.aspx). *Indian J Psychiatry*. 2017;59(4):505-509. doi:10.4103/psychiatry.IndianJPsychiatry\_464\_17
14. Maglione JE, Thomas SE, Jeste DV. [Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia?](https://doi.org/10.1097%2FYCO.0000000000000049). *Curr Opin Psychiatry*. 2014;27(3):173-178. doi:10.1097/YCO.0000000000000049
15. National Institute of Mental Health. [Schizophrenia](https://www.nimh.nih.gov/health/topics/schizophrenia).
16. Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F. [Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers](https://doi.org/10.1007/s00787-017-1026-7). *Eur Child Adolesc Psychiatry*. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7
17. Driver DI, Gogtay N, Rapoport JL. [Childhood onset schizophrenia and early onset schizophrenia spectrum disorders](https://doi.org/10.1016%2Fj.chc.2013.04.001). *Child Adolesc Psychiatr Clin N Am*. 2013;22(4):539-555. doi:10.1016/j.chc.2013.04.001
18. Sher L, Kahn RS. [Suicide in schizophrenia: An educational overview](https://doi.org/10.3390%2Fmedicina55070361). *Medicina (Kaunas)*. 2019;55(7):361. doi:10.3390/medicina55070361
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| Readable Markdown | ### Key Takeaways
- Schizophrenia is a mental disorder that can start with subtle signs like social withdrawal and strange behavior.
- Early symptoms of schizophrenia can look like other mental health conditions, making it hard to diagnose.
- Recognizing early warning signs and getting help from a healthcare provider is important for managing schizophrenia.
[Schizophrenia](https://www.verywellhealth.com/schizophrenia-8597724) is a chronic psychiatric disorder that affects how a person thinks, feels, and behaves. Common early signs of schizophrenia vary by age group and include:
- **Young children:** Delayed development
- **Older kids and teens:** Depression, isolation, behavioral problems (e.g., stealing) or changes (e.g., bizarre or unusual thoughts or actions), and trouble focusing
- **Adults:** Restlessness, anxiety, low energy, not taking care of oneself (e.g., personal hygiene), decrease in work performance, suicidal thoughts, and social withdrawal
It is estimated that schizophrenia affects less than 1% of adults worldwide.
Schizophrenia usually develops slowly, with early warning signs starting before the first severe episode. Knowing these warning signs can help a healthcare provider diagnose schizophrenia sooner and make sure that a person living with the condition gets the care and support that they need.
Westend61 / Getty images
## Early Warning Signs of Schizophrenia
The time during which the early warning signs of schizophrenia are experienced is called the [prodromal stage](https://www.verywellhealth.com/prodromal-schizophrenia-5194244). The onset of schizophrenia can last from months to years. The first signs of schizophrenia can be different depending on how old a person is when the disorder develops.
The age at which someone develops schizophrenia is thought to influence the symptoms they will have. Even though men and women have roughly similar rates of schizophrenia, they tend to develop the condition at slightly different ages.
### Positive Signs
Positive symptoms can be the first signs of schizophrenia. In mental health terms, "positive" means these symptoms are present, not that they are beneficial.
For instance, someone with schizophrenia may experience hallucinations, while someone without the condition would not.
Early positive symptoms might worsen before a severe episode of [psychosis](https://www.verywellhealth.com/psychosis-vs-schizophrenia-5095195). These warning signs include:
- Confusing speech
- Strange and/or intense thoughts and feelings
- New difficulty thinking clearly or concentrating
- Suspiciousness of or uneasiness with others (paranoia)
- Trouble telling reality from fantasy, seeing and/or hearing things that are not there (delusions/hallucinations)
These early warning signs might continue and could worsen, especially without diagnosis and treatment.
### Negative Signs
Negative symptoms of schizophrenia tend to develop later. "Negative" means these traits are absent or reduced.
People with schizophrenia often show fewer typical behaviors, such as the ability to feel pleasure or engage in conversation.
Examples of negative symptoms include:
- Limited talking or no talking
- Having no feelings (flat affect)
- Spending a lot more time alone than usual (withdrawing socially)
- Lack of initiative (for example, not completing tasks at home, work, or school)
- Decline in self-care or personal hygiene
- Being unable to feel pleasure
## Schizophrenia Warning Signs by Age
Schizophrenia can vary from person to person, as individuals may not experience all positive or negative symptoms. The condition can also present differently based on the age when it develops.
### In Young Children
People who are diagnosed with [schizophrenia in childhood](https://www.verywellhealth.com/disorganized-schizophrenia-5097138) have more developmental delays than people who are diagnosed later in life.
Very early developmental warning signs of schizophrenia include:
- **Delayed motor development** (such as not walking until over 18 months old)
- **Delayed speech and/or language development** (such as not speaking meaningful two- or three-word phrases until over 36 months old)
- **Impaired social development at an early age** (such as not using gestures to communicate or failing to regulate facial expressions)
It is important to note that these delays are not always a sign of schizophrenia. There are also other reasons a child may have delays, so itâs important to have them evaluated by their provider.
### In Teenagers
Before the onset of schizophrenia, adolescents often develop changes in behavior. They are likely to end up struggling in schoolâone of the most common issues reported in teens diagnosed with schizophrenia.
Early warning signs of schizophrenia in teens include:
- Difficulty concentrating and paying attention
- Unexplained functional decline
- Increased introversion
- Loneliness
- [Depression](https://www.verywellhealth.com/clinical-depression-7643137)
- Aggression
- Suicidal ideation
- Theft
- Bizarre behaviors
It is hard to diagnose schizophrenia in adolescents because many of the features of the condition are also common during normal childhood development. For example, a normal part of childhood is having vivid imaginations and fantasies. However, these can be misunderstood to be hallucinationsâa symptom of schizophrenia.
It is thought that children might be less likely to have paranoid delusions (the belief that others are out to harm them) than people who develop schizophrenia at an older age.
Ellen Lindner / Verywell
### In Early Adulthood
Schizophrenia typically develops during early adulthood. Its onset is characterized by changes in behavior and a deterioration in functioning in daily life.
The most common early warning signs of schizophrenia include:
- Nervousness and/or restlessness
- Depression
- [Anxiety](https://www.verywellhealth.com/anxiety-attack-5088600)
- Difficulty in thinking clearly or concentrating
- Worrying
- Lack of self-confidence
- Lack of energy and/or slowness
- A worrying drop in grades or job performance
- Social withdrawal and/or uneasiness around other people
### What Are Prodromal Symptoms in Schizophrenia?
Some, but not all, people with schizophrenia experience a prodromal stage before the full-blown disorder happens. The prodromal symptoms of schizophrenia can be somewhat nonspecific and include feeling nervous, anxious, depressed, and having trouble concentrating. It can be hard to tell that these symptoms will ultimately be related to schizophrenia since they are also common in other mental and physical health disorders.
Not everyone will experience these early warning signs at the same time in their lives. According to some studies, these prodromal symptoms can be present for years.
### Over the Age of 45
Most early warning signs of schizophrenia for people over the age of 45 are the same as those for people who develop schizophrenia at a younger age.
Some scientists think that people who develop schizophrenia later in life will have fewer disorganized thinking and negative symptoms than people who develop it earlier.
In the past, studies suggested that people who develop schizophrenia later in life may not have the same symptoms as people diagnosed earlier. However, more recent research suggests that the key features of schizophreniaâlike negative symptomsâare often similar for people who are diagnosed at an older age compared to those who are diagnosed younger.
## When Schizophrenia Symptoms Start
Symptoms usually start to develop in early adulthood, between late adolescence and the early 30s. The disorder typically becomes evident slightly earlier in men than it does in women. The symptoms of schizophrenia often show up between late adolescence and the early 20s in men and between the early 20s and the early 30s in women.
### Early Onset Schizophrenia
When the disorder is diagnosed before the age of 18, it is referred to as early onset schizophrenia (EOS). EOS is rare, with an estimated prevalence of 0.23%. Even more rarely, schizophrenia can develop in very young children. This is called childhood-onset schizophrenia (COS) and it is diagnosed before the age of 13.
According to the National Institute of Mental Health, approximately one in 40,000 children will have COS. It is thought to be extremely uncommon that COS will develop before the age of 10.
### Late-Onset Schizophrenia
Although schizophrenia most commonly starts between late adolescence and the early 30s, it is estimated that up to 20% of patients first have symptoms after the age of 40 years old. Some scientists have identified this as a subtype of schizophrenia called late-onset schizophrenia (LOS).
Women are more likely to be in this group than men. The symptoms typically develop in [menopause](https://www.verywellhealth.com/menopause-4014690), between ages 44 and 49 years old. However, it is still more common for schizophrenia to develop in early adulthood than at this time in life.
## Causes and Risk Factors
Since a lot of the early signs of schizophrenia can also be caused by other conditions (like depression and anxiety), itâs important to understand why some people develop schizophrenia.
While the exact [cause](https://www.verywellhealth.com/disorganized-schizophrenia-5097138) of schizophrenia is not known, there are a few risk factors that researchers think make a person more likely to develop it.
Schizophrenia has a strong genetic component and is highly heritable. Having a family member with schizophrenia increases your risk of developing the disease.
These risk factors will be taken into account regarding a [diagnosis](https://www.verywellhealth.com/schizophrenia-diagnosis-8550221) if you are thought to be experiencing these early warning signs of schizophrenia.
For example, genetics, brain structure and function, and the environment a person grew up in (e.g., exposure to poverty, stress, viruses, and nutritional deficiencies) can all influence whether a person will be diagnosed with schizophrenia in their lifetime.
## Complications
In the early stages of schizophrenia, the disorder can be confused with other common mental health conditions, like depression. It can be hard even for providers to tell them apart since most common early warning signs for schizophrenia are also among the most common initial symptoms for moderate to severe depression.
It is not until the positive symptoms (such as hallucinations, delusions, and disorganized thoughts and speech) of schizophrenia show up that it gets easier to tell apart from other mental health conditions.
Getting the correct diagnosis and connecting people with support and treatment is crucial to keep them safe and help them manage life with the condition.
People are at risk for suicidal thoughts and may act on those thoughts. The risk of suicide for people living with schizophrenia is higher for men and people who were diagnosed at a young age.
Depression has been identified as a major risk factor for suicide among people living with schizophrenia. Having other mental health concerns, like substance use disorder, also increases the risk of suicide among people living with schizophrenia.
If you or your loved one is thinking of or talking about harming themselves, contact someone who can help right away. You can call the toll-free, 24-hour [National Suicide Prevention Lifeline (Lifeline)](https://suicidepreventionlifeline.org/) at 800-237-8255.
If you require immediate emergency care, call 911 for emergency services or go to the nearest hospital emergency room.
## When to See a Healthcare Provider
Schizophrenia usually develops gradually, so it can be hard to pinpoint when changes in behavior start or whether they are something to worry about. In general, if you recognize that youâre having a pattern of concerning behaviors, take it as a sign that you need to talk to a provider about what youâre going through.
If you are aware of the warning signs of schizophrenia at each age, you may be more likely to spot them early. While these changes might not be concerning by themselves, if you or a loved one are having several of them, talk to a mental health professional. Keep in mind that it can be difficult for people to get helpâespecially if they are experiencing symptoms such as [paranoia](https://www.verywellhealth.com/paranoid-delusions-5095908). | |||||||||
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