Schizophrenia is a persistent mental disorder with symptoms that can have a devastating impact on a patient’s quality of life. Symptoms generally emerge during late adolescence or early adulthood.1 Their appearance during this time often results in significantly negative effects on daily functioning and achievement of adult milestones, such as completing an education, obtaining employment, and starting a family.

Reviewing the Symptoms of Schizophrenia

Symptoms of schizophrenia can be characterized as negative symptoms, positive symptoms, and cognitive impairment. These are often referred to as symptom domains and require different treatment approaches. Negative symptoms include a flattened emotional affect, an inability to feel pleasure, a loss of will or desire, and social withdrawal, while positive symptoms include psychotic symptoms such as hallucinations and delusions.2 Cognitive impairment associated with schizophrenia is pervasive, as nearly all patients show some degree of impairment in attention, memory, and executive functioning, which often worsens with increasing disease severity.3 Notably, negative symptoms and cognitive impairment commonly manifest before the first emergence of hallucinations and delusions and often persist between acute psychotic episodes.4,5  

A hallmark symptom of schizophrenia is disorganized thought, which often presents as jumbled speech and behavior. Difficulty with speech can range from cycling through multiple topics in quick succession to speech that is nearly or completely unintelligible. Meanwhile, the patient may also display behavior that ranges from a childlike state to bouts of uncontrolled anger or agitation.2  

Impact of Schizophrenia Symptoms

Ultimately, the effect that schizophrenia symptoms can have on a patient’s quality of life is profound, as severe negative and cognitive symptoms are known to result in a significantly lower quality of life.6 Additionally, as the severity of schizophrenia symptoms, particularly negative symptoms, increases, a greater reduction is seen in daily functioning and personal relationships.6,7 This negative impact may be further enhanced by demographic traits such as older age or a lower level of education.6

Furthermore, loneliness is common and often more severe in patients with schizophrenia. This is ultimately associated with worsening emotional health.8 Positive symptoms of schizophrenia are more positively correlated with loneliness, signifying the isolating effect these symptoms may have due to patients’ perceptions of those around them.8

How Symptoms of Schizophrenia Result in Impaired Functioning  

The significant impact these symptoms have on the ability to live an independent, successful life cannot be understated. As patients may instinctively self-isolate due to their symptoms, their personal relationships may deteriorate as a result, and the ability to hold a job can become increasingly challenging. Unemployment and lowered work productivity are a significant indirect cost for patients with schizophrenia.9

Symptoms of schizophrenia can also impact patients’ independence due to their frequent need for caregiver support. This can range from emotional and financial support to assistance with daily activities.10 A lack of independence reduces patients’ ability to hit expected milestones in adulthood and may increase the burden of disease for both them and their caregivers.

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References:

  1. Schizophrenia. National Institute of Mental Health. Accessed December 5, 2024. https://www.nimh.nih.gov/health/statistics/schizophrenia
  2. Schultz SH, North SW, Shields CG. Schizophrenia: a review. Am Fam Physician. 2007;75(12):1821-1829. 
  3. Gebreegziabhere Y, Habatmu K, Mihretu A, Cella M, Alem A. Cognitive impairment in people with schizophrenia: an umbrella review. Eur Arch Psychiatry Clin Neurosci. 2022;272(7):1139-1155. doi:10.1007/s00406-022-01416-6
  4. Mosolov SN, Yaltonskaya PA. Primary and secondary negative symptoms in schizophrenia. Front Psychiatry. 2022;12:766692. doi:10.3389/fpsyt.2021.766692  
  5. McCutcheon RA, Keefe RSE, McGuire PK. Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. Mol Psychiatry. 2023;28(5):1902-1918. doi:10.1038/s41380-023-01949-9 
  6. Narvaez JM, Twamley EW, McKibbin CL, Heaton RK, Patterson TL. Subjective and objective quality of life in schizophrenia. Schizophr Res. 2008;98(1-3):201-208. doi:10.1016/j.schres.2007.09.001  
  7. Marder SR, Umbricht D. Negative symptoms in schizophrenia: newly emerging measurements, pathways, and treatments. Schizophr Res. 2023;258:71-77. doi:10.1016/j.schres.2023.07.010
  8. Eglit GML, Palmer BW, Martin AS, Tu X, Jeste DV. Loneliness in schizophrenia: construct clarification, measurement, and clinical relevance. PLoS One. 2018;13(3):e0194021. doi:10.1371/journal.pone.0194021
  9. Kadakia A, Catillon M, Fan Q, et al. The economic burden of schizophrenia in the United States. J Clin Psychiatry. 2022;83(6):22m14458. doi:10.4088/JCP.22m14458
  10. Yıldız M, Demir Y, Kırcalı A, İncedere A. Caregiver burden in schizophrenia and autism spectrum disorders: a comparative study. Psychiatry Investig. 2021;18(12):1180-1187. doi:10.30773/pi.2021.0165