Schizophrenia is a mental health condition that can emerge during the teenage years. Recognizing early signs can help with timely intervention and lead to improved outcomes.

As a child makes the transition into adolescence, behavior changes are common. However, some changes could be signs of a mental health condition.

Teens with schizophrenia may initially exhibit a decline in academic performance and changes in sleep patterns, behavior, and personal hygiene habits. More advanced symptoms include hallucinations, disorganized speech, and social withdrawal. They may also experience issues with concentration, memory, and problem-solving.

This article outlines the early signs and treatment options for teens with schizophrenia.

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According to a 2016 review, early onset schizophrenia involves symptoms that appear before a person is 18 years old. It states that in childhood onset schizophrenia, symptoms start to appear before the person is 13 years old.

Generally, people with schizophrenia receive a diagnosis at 16–30 years old, after experiencing their first episode of psychosis. However, gradual signs and changes often occur before the initial psychosis episode. These can include changes in mood, thinking, and social functioning.

A 2020 study notes that having an earlier onset age may correlate with more negative outcomes.

Schizophrenia can manifest in a variety of ways in teens. Initial symptoms are often vague and can be symptoms of other mental health conditions. The later symptoms are generally more distinct.

Early signs

Early signs of schizophrenia in teens typically include changes in thinking, emotions, and behavior.


Changes in thought processes usually appear in the initial stages of schizophrenia. What doctors refer to as “working memory deficits” related to schizophrenia can begin appearing in childhood.

This refers to difficulties in temporarily storing and manipulating information in the mind. It is also a common symptom of ADHD and learning disabilities.

Issues with working memory show up as difficulty with organizing thoughts and remembering details, which can lead to challenges in school.


Sudden and intense mood swings are early symptoms of schizophrenia in teens. This may include a sudden emotional switch from calm to angry or content to depressed.

The teen may seem upset or agitated even when they cannot identify the cause of the aggravation. However, schizophrenia can also have the opposite effect on emotions, leading to feelings of emptiness or a lack of emotion. These changes can also lead to shifts in behavior.


An adolescent experiencing the early stages of schizophrenia may exhibit a range of behaviors, such as:

  • a lack of interest in spending time with friends
  • neglecting personal hygiene
  • frequent emotional outbursts
  • losing important things
  • keeping a disorganized room

Later signs

Later signs of schizophrenia in teens may be more distinct than early signs. These include negative, psychotic, and cognitive symptoms.

Negative symptoms

As the condition progresses, a teen with schizophrenia can experience negative symptoms. These occur when a person starts to withdraw from reality.

People with negative symptoms often seem to lack emotion and stop showing interest in social interactions. This may include:

  • no longer caring about personal hygiene
  • feeling disconnected from emotions
  • avoiding people, including friends and loved ones

Psychotic symptoms

Doctors often do not diagnose schizophrenia until after the first episode of psychosis.

Psychotic symptoms involve a disruption of an individual’s thoughts, perceptions, and overall sense of reality. The psychotic symptoms of schizophrenia typically fall into two main categories: delusions and hallucinations.

Delusions are false beliefs that persist despite evidence to the contrary. Common types of delusions in schizophrenia include:

  • paranoid delusions, which involve a person believing others are plotting against them
  • grandiose delusions, which involve a person thinking they have exceptional abilities or status
  • delusions of reference, which are beliefs that random events or stimuli have personal significance

Hallucinations involve perceiving things that are not present in reality. Auditory hallucinations, particularly hearing voices, are the most common type experienced in schizophrenia. However, hallucinations can also affect other senses, such as vision, smell, touch, and taste.

Cognitive symptoms

Cognitive symptoms typically include issues with attention, memory, and concentration. These may make it difficult for a person to follow conversations, learn new things, and remember important events or appointments.

In its later stages, schizophrenia can cause disorganized thinking. This refers to difficulties in organizing thoughts and making logical connections. It can result in fragmented or incoherent speech, which can make it hard for others to understand a person.

Teens with schizophrenia may also shift discussion topics quickly. They may continue to experience difficulty focusing and not be able to process information to make decisions.

Behavioral changes

It is common for teens with schizophrenia to engage in behavior that seems unusual. This may include:

  • childlike silliness
  • agitation that seems to appear out of nowhere
  • repeated movements that lack intention
  • catatonia, which occurs when the teen seems dazed and does not respond to their surroundings

Doctors use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR), to diagnose schizophrenia in teenagers. The process involves a comprehensive evaluation by a mental health professional.

They typically employ a multifaceted approach to reach an accurate diagnosis. This includes conducting thorough interviews with the teenager and their family, gathering information about symptoms and their duration, and assessing the effects on daily functioning.

They may also work with a healthcare professional to review medical records and rule out other possible causes of the symptoms.

Treating schizophrenia in teens typically involves a combination of medication and psychosocial interventions.

Antipsychotic medications can help with managing symptoms. Certain forms of psychotherapy, such as cognitive behavioral therapy or family therapy, can provide support and may help with developing skills to manage and live with symptoms.

Early intervention and ongoing monitoring are important for optimizing treatment outcomes and improving a person’s quality of life.

Parents and caregivers can consider several tips that may help with supporting a teenager with schizophrenia:

  • Self-care: It is important for parents and caregivers to remember to prioritize their own mental health. It may be helpful to join a support group made up of other people who care for teens experiencing mental health issues.
  • Learning: Discovering information about schizophrenia, including its symptoms, treatment options, and available support resources, can help people better understand the condition and how to provide appropriate care.
  • Maintaining open communication: This can involve fostering nonjudgmental communication and encouraging the teen to express their feelings and concerns.
  • Monitoring treatment: A person may need to gently remind the teen about the importance of treatment adherence. They may also help them with remembering to take prescribed medication on time and attending therapy sessions.
  • Creating structure: Having routines and clear expectations at home can aid in providing stability.
  • Offering emotional support: This may involve providing empathy and reassurance.
  • Encouragement: It may help to gently encourage the teen to engage socially with their peers if withdrawal is a concern.

The following are answers to some questions people regularly ask about schizophrenia.

What are the beginning stages of schizophrenia?

The beginning stages of schizophrenia typically involve early signs such as social withdrawal, changes in behavior, altered perception, disorganized thinking, and emotional instability.

What are three coping strategies for schizophrenia?

Coping strategies for schizophrenia may include:

  • medication adherence
  • engaging in therapy or support groups
  • developing a routine with structured activities and self-care practices

Schizophrenia typically emerges during the teenage years. Early signs include social withdrawal, changes in behavior, altered perception, disorganized thinking, and emotional instability.

Treatment methods may include medication and participating in individual or group therapy. It may also help to establish a routine that involves regular self-care.

Learning about the condition, maintaining open communication, and seeking support may be helpful for parents and caregivers of teens with schizophrenia.