Schizophrenia Onset: When Do Symptoms Usually Start?

Medically Reviewed by Zilpah Sheikh, MD on August 08, 2024
5 min read

Schizophrenia usually takes hold after puberty. Most people are diagnosed in their late teens to early 30s. It's rare to develop this mental health disorder before age 12 or after age 40.

Schizophrenia onset tends to be slightly earlier for those assigned male at birth than for those assigned female. On average, men are diagnosed in their late teens to early 20s. Women tend to get diagnosed in their late 20s to early 30s.

No one knows exactly why schizophrenia onset often happens during late adolescence, but there are many theories.

Research suggests the disorder is caused by a combination of something in your genes and things that happen while your brain is developing. If you're vulnerable, the start of symptoms may be set off by a change in your environment or your body.

Your brain changes and develops during your late teens and early 20s. These shifts might trigger the disease in people who are at a risk of it.

Some scientists believe it has to do with development in an area of the brain called the frontal cortex. Others think it has to do with too many connections between nerve cells being eliminated as the brain matures.

Hormones also play a major role in puberty. One theory is that women get schizophrenia later than men because they go through puberty earlier and the hormone estrogen might somehow protect them.

Adolescence is also a time when many people experiment with marijuana and other recreational drugs. Research has linked the use of drugs, especially cannabis, to a higher risk of schizophrenia.

Know how to recognize the signs of schizophrenia in teens.

Schizophrenia can be hard to diagnose for a few reasons. One is that people with the disorder often don't realize they're ill, so they're unlikely to go to a doctor for help.

Another issue is that many of the changes leading up to schizophrenia, called the prodrome, can mirror other normal life changes. For example, a teen who's developing the illness might drop their group of friends and take up with new ones. They may also have trouble sleeping or suddenly start coming home with poor grades. That's not unusual for any teen and may not raise a red flag.

Other subtle signs can include mood swings, irritability, spending time alone, and trouble staying on task.

The vast majority of people with those behaviors will not go on to develop schizophrenia, and it's very hard to figure out who might. Doctors have a number of assessments they use to try to determine who's at most risk so they can get treatment as early as possible.

Early intervention with medications or psychotherapy could keep the condition from getting worse for at least some amount of time.

Learn more about the prodrome phase of schizophrenia.

Schizophrenia is a syndrome. People with schizophrenia have several types of symptoms:

Hallucinations. You hear voices or see or smell things that others say aren't there. The voices might criticize or threaten you. They might tell you to do things you otherwise wouldn't.

Delusions. You believe things that aren't true, even when others show you proof or share facts that explain why your beliefs are wrong. Delusions can seem bizarre to others. For example, you might think that the TV is sending you special messages or that the radio is broadcasting your thoughts for everyone to hear. You might also feel paranoid and believe that others are trying to harm you.

Thought disorders. You might have trouble organizing your thoughts, and you might speak in a way that's hard for others to understand. Perhaps you stop talking in the middle of a thought because you feel like it's been taken out of your head. This is called thought withdrawal. Another type of disordered thinking, called thought blocking, happens when someone has a sudden stopping of their flow of thinking, and as a consequence, they may become silent until a new thought enters their mind.

Movement disorders. You might move your body over and over again as if you're upset, or you might stop moving and responding. Doctors call this catatonia.

Negative symptoms. Maybe you speak in a dull, flat tone; have trouble following through; lack interest in your daily life; and find it hard to keep up relationships. You might appear to be depressed. But while sadness, tearfulness, and other symptoms point to depression, so-called negative symptoms more likely point to a problem with the way the brain works.

Read more about the symptoms of schizophrenia.

In general, schizophrenia onset before age 18 is considered early-onset and before age 13 may be called childhood or very early-onset schizophrenia. However, different doctors and scholars may use different terms and age ranges.

Schizophrenia is extremely rare in very young children, but it can happen. Signs include:

  • Talking delays
  • Late crawling or walking
  • Lack of eye contact
  • Movements like arm flapping or rocking
  • Trouble controlling emotions and impulses
  • Attention issues
  • Problems telling the difference between dreams or make-believe and reality
  • Trouble managing daily tasks like bathing and brushing teeth

Parents of teens might notice:

  • Not spending as much time with friends and family
  • Drop in school performance
  • Trouble sleeping
  • Bad mood
  • Depression
  • No motivation
  • Using drugs or alcohol
  • Uncharacteristic behavior

Teens are less likely to have delusions but more likely to have visual hallucinations.

Find out more on early childhood schizophrenia symptoms.

It's less common, but sometimes, schizophrenia onset can take place later in life. Experts consider late-onset schizophrenia to mean a diagnosis between the ages of 40 and 60, while a diagnosis beyond age 60 is considered very late-onset schizophrenia-like psychosis.

People with late-onset schizophrenia are more likely to have symptoms like delusions and hallucinations. They're less likely to have negative symptoms, disorganized thoughts, impaired learning, or trouble understanding information.

Doctors think genetics may be to blame, just as it is with early-onset schizophrenia. They also think late-onset might be a subtype that doesn't affect the person until the right trigger appears. People with cognitive, vision, or hearing problems or those who are suspicious, isolated, or reclusive may be more likely to get it.

Schizophrenia onset most often takes place between your late teens and early 30s. People assigned male at birth are usually diagnosed in their late teens to early 20s, while people assigned female at birth tend to get diagnosed in their late 20s to early 30s. It's rare to develop this mental health condition before age 12 or after age 40. Brain changes during adolescence may explain why symptoms usually appear at that age.