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Schizophrenia

Fact sheet
Reviewed April 2016


Key facts

  • Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide.
  • Schizophrenia is characterized by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common experiences include hearing voices and delusions.
  • Worldwide, schizophrenia is associated with considerable disability and may affect educational and occupational performance.
  • People with schizophrenia are 2-2.5 times more likely to die early than the general population. This is often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases.
  • Stigma, discrimination and violation of human rights of people with schizophrenia is common.
  • Schizophrenia is treatable. Treatment with medicines and psychosocial support is effective.
  • Facilitation of assisted living, supported housing and supported employment are effective management strategies for people with schizophrenia.

Symptoms

Schizophrenia is characterized by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common experiences include:

  • Hallucination: hearing, seeing or feeling things that are not there.
  • Delusion: fixed false beliefs or suspicions that are firmly held even when there is evidence to the contrary.
  • Abnormal Behaviour: strange appearance, self-neglect, incoherent speech, wandering aimlessly, mumbling or laughing to self.

Magnitude and impact

Schizophrenia affects more than 21 million people worldwide but is not as common as many other mental disorders. It is more common among males (12 million), than females (9 million). Schizophrenia also commonly starts earlier among men.

Schizophrenia is associated with considerable disability and may affect educational and occupational performance.

People with schizophrenia are 2-2.5 times more likely to die early than the general population. This is often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases.

Stigma, discrimination and violation of human rights of people with schizophrenia is common.

Causes of schizophrenia

Research has not identified one single factor. It is thought that an interaction between genes and a range of environmental factors may cause schizophrenia.

Psychosocial factors may also contribute to schizophrenia.

Services

More than 50% of people with schizophrenia are not receiving appropriate care. Ninety per centof people with untreated schizophrenia live in low- and middle- income countries. Lack of access to mental health services is an important issue. Furthermore people with schizophrenia are less likely to seek care than the general population.

Management

Schizophrenia is treatable. Treatment with medicines and psychosocial support is effective. However, the majority of people with chronic schizophrenia lack access to treatment.

There is clear evidence that old-style mental hospitals are not effective in providing the treatment that people with mental disorders need and violate basic human rights of persons with mental disorders. Efforts to transfer care from mental health institutions to the community need to be expanded and accelerated. The engagement of family members and the wider community in providing support is very important.

Programmes in several low- and middle- income countries (e.g. Ethiopia, Guinea-Bissau, India, Iran, Pakistan, Tanzania) have demonstrated the feasibility of providing care to people with severe mental illness through the primary health-care system by:

  • training primary health-care personnel;
  • providing access to essential drugs;
  • supporting families in providing home care;
  • educating the public to decrease stigma and discrimination;
  • enhancing independent living skills through recovery-oriented psychosocial interventions (e.g., life skills training, social skills training) can be offered for people with schizophrenia and for their families and/or caregivers; and
  • facilitating independent living, if possible or assisted living ,supported housing and supported employment for people with schizophrenia. This can act as a base for people with Schizhophrenia to achieve recovery goals. People affected by schizophrenia often face difficulty in obtaining or retaining normal employment or housing opportunities.

Human rights violations

People with schizophrenia are prone to human rights violations both inside mental health institutions and in communities. Stigma of the disorder is high. This contributes to discrimination, which can in turn limit access to general health care, education, housing and employment.

WHO response

WHO's Mental Health Gap Action Programme (mhGAP), launched in 2008, uses evidence-based technical guidance, tools and training packages to expand service in countries, especially in resource-poor settings. It focuses on a prioritized set of conditions, directing capacity building towards non-specialized health-care providers in an integrated approach that promotes mental health at all levels of care. Currently mhGAP is implemented in more than 80 Member States.

The WHO QualityRights Project involves improving the quality of care and human rights conditions in mental health and social care facilities and to empower organizations to advocate for the health of people with mental disorders.

WHO’s Mental Health Action Plan 2013-2020,endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the Action Plan is to shift services from institutions to the community.