Symptoms

Research indicates that symptoms in childhood strongly predict disease in adulthood. In one long-term study, over 40% of people with schizophrenia who developed the disease in young adulthood had reported psychotic symptoms by age 11. For children with a family history of schizophrenia, the following inherited traits may be warning signs:

• Deficits in working (short-term) and verbal memory
• Impairments in gross motor skills (the child’s ability to control different parts of the body)
• Attention deficits
• Mixed-handedness (the use of different hands for different tasks), particularly in females
• Hallucinations or delusions
• A decline in verbal memory, IQ, and other mental functions

The hallucinations or delusions did not include normal childhood fantasies.

Some experts suggest that screening using brain imaging techniques (possibly followed by treatment) may help prevent nerve damage and improve outcome.

Most often, early warning signs go unnoticed and schizophrenia usually becomes evident for the first time in late adolescence or early adulthood. Schizophrenia that starts in childhood or adolescence tends to be severe. It should be strongly noted that the traits discussed above, even combinations of them, can be present without schizophrenia.

Symptoms of Progression to Full-Blown Schizophrenia

The course of the disease varies from one patient to the next. Symptoms of psychosis can become gradually or suddenly evident.

• In up to a third of patients, the disease is unrelenting and progresses from the first episode onward.
• In others, schizophrenia follows a fluctuating course with psychotic flare-ups, followed by remissions.
• In one study, 31% of patients experienced a complete remission of symptoms within 3 years after one or more episodes. Women are more likely to go into remission, possibly because of some protective effect of estrogen on the brain.

Typically, patients develop considerable cognitive dysfunction (disordered thinking) within the first 4 - 5 years of the onset of psychotic symptoms. There is some evidence that the physical disease process in schizophrenia is progressive, as with Alzheimer's and Parkinson's. However, schizophrenia does not progress in the same way as those two diseases. Unlike Parkinson's and Alzheimer's, cognitive function usually eventually stabilizes. Psychosis, disorganized thought, and negative symptoms often improve over time, although, even in such cases, deficits in verbal memory usually persist. (Thought disorder often improves along with improvements in negative symptoms.)