There's no single test for schizophrenia and the condition is usually diagnosed after assessment by a specialist in mental health.
If you're concerned you may be developing symptoms of schizophrenia, see your GP as soon as possible. The earlier schizophrenia is treated, the better.
Your GP will ask about your symptoms and check they're not the result of other causes, such as recreational drug use.
Community mental health team
If a diagnosis of schizophrenia is suspected, your GP should refer you promptly to your local community mental health team (CMHT).
CMHTs are made up of different mental health professionals who support people with complex mental health conditions.
A member of the CMHT team, usually a psychiatrist or a specialist nurse, will carry out a more detailed assessment of your symptoms. They'll also want to know your personal history and current circumstances.
To make a diagnosis, most mental healthcare professionals use a diagnostic checklist.
Schizophrenia can usually be diagnosed if:
- you've experienced one or more of the following symptoms most of the time for a month: delusions, hallucinations, hearing voices, incoherent speech, or negative symptoms, such as a flattening of emotions
- your symptoms have had a significant impact on your ability to work, study or perform daily tasks
- all other possible causes, such as recreational drug use or bipolar disorder, have been ruled out
Sometimes it might not be clear whether someone has schizophrenia. If you have other symptoms at the same time, a psychiatrist may have reason to believe you have a related mental illness, such as:
- bipolar disorder (manic depression) – people with bipolar disorder swing from periods of elevated moods and extremely active, excited behaviour (mania) to periods of deep depression; some people also hear voices or experience other kinds of hallucinations, or may have delusions
- schizoaffective disorder – this is often described as a form of schizophrenia because its symptoms are similar to schizophrenia and bipolar disorder, but schizoaffective disorder is a mental illness in its own right; it may occur just once in a person's life, or come and go and be triggered by stress
You should also be assessed for post-traumatic stress disorder, depression, anxiety and substance misuse.
Getting help for someone else
As a result of their delusional thought patterns, people with schizophrenia may be reluctant to visit their GP if they believe there's nothing wrong with them.
It's likely someone who has had acute schizophrenic episodes in the past will have been assigned a care co-ordinator. If this is the case, contact the person's care co-ordinator to express your concerns.
If someone is having an acute schizophrenic episode for the first time, it may be necessary for a friend, relative or another loved one to persuade them to visit their GP.
In the case of a rapidly worsening schizophrenic episode, you may need to go to the accident and emergency (A&E) department, where a duty psychiatrist will be available.
If a person who is having an acute schizophrenic episode refuses to seek help, their nearest relative can request that a mental health assessment is carried out. The social services department of your local authority can advise how to do this.
In severe cases, people can be compulsorily detained in hospital for assessment and treatment under the Mental Health Act (2007).
If you or a friend or relative are diagnosed with schizophrenia, you may feel anxious about what will happen. You may be worried about the stigma attached to the condition, or feel frightened and withdrawn.
It's important to remember that a diagnosis can be a positive step towards getting good, straightforward information about the illness and the kinds of treatment and services available.
Diagnosing children and young people
Children and young people with a first episode of schizophrenia should be referred urgently to a specialist mental health service.
This should be either Child and Mental Health Adolescent Services (CAMHS) for those aged up to 17, or an early intervention service for those aged 14 years or over, that includes a consultant psychiatrist with training in child and adolescent mental health.
For more information, see the National Institute for Health and Care Excellence (NICE) guidelines on psychosis and schizophrenia in children and young people.