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How Often Is Schizophrenia Misdiagnosed

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Addressing A Misdiagnosed Mental Illness

Could You Have Been Misdiagnosed With Schizophrenia?

If you have been diagnosed with a mental illness, and you find that the medication or method of therapy prescribed has failed to alleviate your symptoms, the first thing you must do is consult a specialist for a second opinion. Mental health misdiagnosis happens, so you must begin treatment with a thorough psychological assessment by a skilled provider, who will hopefully be able to better identify the condition or disorder, and offer a more effective treatment plan.

Making your family and friends a part of the diagnostic process can help as well. Wherepossible, have those who are close to you speak with the specialist, so that they can bring up any observations regarding your emotions and pattern of behavior. This can help where you may have missed some symptoms, or forgotten to mention them to your health provider.

Why Is Schizophrenia Misdiagnosed

To be diagnosed with schizophrenia, an individual has to have at least two of these symptoms, at least one of which has to be among the top three:

  • Delusions
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Other negative behaviors such as limited or no changes in tone of voice or facial expressions, a lack of personal hygiene, or a lack of motivation to participate in recreational activities

While these symptoms are tell-tale signs of schizophrenia, they are also associated with a broad range of other disorders. Hallucinations, for example, are considered by many to be the most prominent symptom of schizophrenia. However, they may also occur with migraines, brain tumors, epilepsy, PTSD, sleep disorders, and drug use. Disorganized speech may be linked to anxiety, depression, a traumatic brain injury, or a mood disorder. Depression may be connected to a lack of personal hygiene or motivation to engage with once-enjoyed activities. Nutritional deficiencies, metabolic disorders, hyperthyroidism, and even allergies can all mimic schizophrenia.

Self-diagnosing schizophrenia is even more challenging. Some of the characteristics of schizophrenia, as well as disorders that mimic it, are poor insight, delusions, hallucinations and difficulty with thought processes. These can all cloud the individuals judgment and make them unable to accurately evaluate their own mental status.

How To Get The Right Diagnosis The First Time

Being correctly diagnosed can be lifesaving. If I had the right diagnosis, I wouldnt have tried to commit suicide, says Whitehead.

According to Danovitch, the key to getting the right mental health diagnosis often lies in patience and empowerment. Misdiagnosis can happen when you rush to make a diagnosis, he explains.

Seeing a professional who specializes in mental health disorders, such as a psychiatrist, can also increase your odds of receiving the correct diagnosis.

Danovitch says he believes people should become experts on their own condition once theyre diagnosed and ask questions as much as possible, so they can become empowered enough to know what they deserve and the evidence-based interventions available and what the goal of treatment is.

For people like Carson and Whitehead, the right diagnosis and treatment changed their lives.

I didnt think I would ever be alone without my husband and do so well, says Whitehead, who recently flew back from Florida after two weeks of caring for her newborn grandson. Im in a really good place now.

If you or someone you know needs mental health help, contact the National Alliance on Mental Illness at 800-950-NAMI , or the Substance Abuse and Mental Health Services Administration National Helpline at 800-662-HELP . If you are in immediate danger, call 911 or the National Suicide Prevention Lifeline at 800-273-8255.

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Risk Factors Etiology And Pathophysiology

Schizophrenia has a prevalence of 1 percent in all cultures and is equally common in men and women.1 Men typically present with the disease in their late teenage years or early 20s, whereas women generally present in their late 20s or early 30s.

A family history of schizophrenia is the most significant risk factor .3 Other hypothetical risk factors include season and location of birth, socioeconomic status, and maternal infections. However, data supporting these ideas are inconclusive.3,4

Third-degree relative

Second-degree relative

2 to 6

First-degree relative

6 to 17

Third-degree relative

Second-degree relative

2 to 6

First-degree relative

6 to 17

Information from reference 2.

Schizophrenia appears to be a polygenic disorder with environmental and developmental factors mediating a person’s likelihood of becoming schizophrenic.2 It is unknown if the range of severity and clinical manifestations reflect problems in different brain regions, in different causalities, or in different diseases that share some phenotypic features.2

The neurotransmitter dopamine also plays an important role. For example, drugs that cause psychoses similar to the positive symptoms of schizophrenia increase dopaminergic neurotransmission, and almost all antipsychotics decrease dopaminergic neurotransmission.9 Still, dopaminergic pathways cannot entirely explain the pathophysiology of schizophrenia, and the roles of other neurotransmitters are being investigated.9

Community Mental Health Team


If a diagnosis of schizophrenia is suspected, the GP should refer you to your local community mental health team .

CMHTs are made up of different mental health professionals who support people with complex mental health conditions.

A member of the CMHT team, usually a psychiatrist or a specialist nurse, will carry out a more detailed assessment of your symptoms. They’ll also want to know your personal history and current circumstances.

To make a diagnosis, most mental healthcare professionals use a diagnostic checklist.

Schizophrenia can usually be diagnosed if:

  • you’ve experienced 1 or more of the following symptoms most of the time for a month: delusions, hallucinations, hearing voices, incoherent speech, or negative symptoms, such as a flattening of emotions
  • your symptoms have had a significant impact on your ability to work, study or perform daily tasks
  • all other possible causes, such as recreational drug use or bipolar disorder, have been ruled out

Also Check: What Are The Three Stages Of Schizophrenia

Frequently Asked Questions About Schizophrenia

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.

Schizophrenia is a severe and debilitating brain and behavior disorder affecting how one thinks, feels and acts. People with schizophrenia can have trouble distinguishing reality from fantasy, expressing and managing normal emotions and making decisions. Thought processes may also be disorganized and the motivation to engage in lifes activities may be blunted. Those with the condition may hear imaginary voices and believe others are reading their minds, controlling their thoughts or plotting to harm them.

While schizophrenia is a chronic disorder, it can be treated with medication, psychological and social treatments, substantially improving the lives of people with the condition.

A moving presentation by Dr. Kafui Dzirasa on Schizophrenia
View Webinar on Identifying Risk Factors and Protective Pathways for Schizophrenia

Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30.

Learn more about childhood-onset schizophrenia from this expert researcher:

Find answers to more questions about Schizophrenia in our Ask the Expert section.

Study Suggests Overdiagnosis Of Schizophrenia

Reported symptoms of anxiety and hearing voices most common reasons for misdiagnosis by non-specialty physicians.

In a small study of patients referred to the Johns Hopkins Early Psychosis Intervention Clinic , Johns Hopkins Medicine researchers report that about half the people referred to the clinic with a schizophrenia diagnosis didnt actually have schizophrenia. Schizophrenia is a chronic, severe and disabling disorder marked by disordered thinking, feelings and behavior. People who reported hearing voices or having anxiety were the ones more likely to be misdiagnosed.

In a report of the study in the March issue of the Journal of Psychiatric Practice, the researchers say that therapies can vary widely for people with schizophrenia, bipolar disorder, major depression or other serious types of mental illness, and that misdiagnosis can lead to inappropriate or delayed treatment.

In a small study of patients referred to the Johns Hopkins Early Psychosis Intervention Clinic , Johns Hopkins Medicine researchers report that about half the people referred to the clinic with a schizophrenia diagnosis didnt actually have schizophrenia. Schizophrenia is a chronic, severe and disabling disorder marked by disordered thinking, feelings and behavior. People who reported hearing voices or having anxiety were the ones more likely to be misdiagnosed.

Chelsey Coulter of the University of Pittsburgh is also an author on the study.

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Icipants And Study Design

In this cross-sectional study, a random sample of 320 patients with severe psychiatric disorders from the outpatient clinic of Amanuel Mental Specialized Hospital was invited to participate. This hospital is the only psychiatric hospital in Ethiopia. Data were collected between May and July 2017. The participant had to meet the following criteria: adults positive for severe psychiatric disorders by the structured clinical interview for DSM-V-TR axis disorders criteria having the capacity to consent.

Symptoms And Signs Of Schizophrenia

Misdiagnosis: Schizophrenia or Lyme Disease?

Schizophrenia is a chronic illness that may progress through several phases, although duration and patterns of phases can vary. Patients with schizophrenia tend to have had psychotic symptoms an average of 12 to 24 months before presenting for medical care but the disorder is now often recognized earlier in its course.

Symptoms of schizophrenia typically impair the ability to perform complex and difficult cognitive and motor functions thus, symptoms often markedly interfere with work, social relationships, and self-care. Unemployment, isolation, deteriorated relationships, and diminished quality of life are common outcomes.

Read Also: What Are The Three Stages Of Schizophrenia

Its Easy To Live In Denial

Even though your loved one isnt functioning well, isnt meeting their own expectations in life, and is using alcohol or drugs to cope, they may not see theres a problem.

Because of the natural urge to protect those you love, families can stay in denial, as well.

Its often the college that sends a young adult to the hospital for the first time because of erratic behavior or an overdose. The parents get involved only because the college requests their child be evaluated by a psychiatrist.

Families often dont seek help on their own, says Dr. Bowers.

They may continue to struggle try to understand their loved ones symptoms. Or ignore those symptoms until they escalate, sometimes into violent behavior.

But early, continuous treatment is critical, she stresses. Without help, a young adults problems will continue especially if they use drugs or alcohol.

If you find them up all hours of the night, or painting their room black, or too irritable without their meds, or scaring their little sister, call the doctor, she says. And encourage them to keep their appointments.

Treating Women With Schizophrenia

Though treatment for mental illness is not typically separated by gender, clinicians serve women best by considering their unique experience of schizophrenia as well as the unique challenges they face. Because women have later onset of the illness and are less likely to experience affective symptoms, clinicians must be careful to rule out other mental illnesses, such as schizoaffective disorder or bipolar disorder, when giving a diagnosis of schizophrenia.

Treatment for women with schizophrenia should include psychoeducation and support for the needs of mothers with children. Antipsychotic medication can affect the ability to breast feed and the amount of energy a mother has to parent her children.7 Treatment plans tailored for women should include education about physical health as well. Women with schizophrenia are less likely to care for their physical health. This leaves them at risk for untreated breast cancer, osteoporosis, and thyroid conditions. Mental health professionals should also consider creating safety plans for women with schizophrenia who are at increased risk for committing suicide.

Recommended Reading: What Are The Three Stages Of Schizophrenia

The Turning Point: Adolescence

An interaction between something in your genes and something in your environment probably causes the disease. Researchers still have a lot to learn about it, but it’s likely that many things play a role. Some, like exposure to a virus or malnutrition , might have happened while you were still in your mother’s womb. For vulnerable individuals, cannabis use can increase the risk of developing psychotic disorders such as schizophrenia.

No one knows exactly why it usually crops up in late adolescence, but there are many theories.

Your brain changes and develops a lot during puberty. These shifts might trigger the disease in people who are at risk for 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. Know how to recognize the signs of schizophrenia in teens.

What Is The Typical Age Of Onset For Schizophrenia

Hanipsych, comorbidity in schizophrenia

Men and women are equally likely to get this brain disorder, but guys tend to get it slightly earlier. On average, men are diagnosed in their late teens to early 20s. Women tend to get diagnosed in their late 20s to early 30s. People rarely develop schizophrenia before they’re 12 or after they’re 40.

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Can A Person Have Bipolar Disorder And Schizophrenia

If you have bipolar disorder, schizophrenia, or schizoaffective disorder, you may recognize many of your symptoms in descriptions of these conditions. However, there are variations in the symptoms you might experience. The symptoms of schizophrenia and bipolar disorder can vary by person no two cases are exactly alike.

How DID Symptoms Are Mistaken For Bipolar Disorder. Several symptoms of DID appear similar to symptoms of bipolar disorder. People with DID can appear to change moods frequently. While this is actually caused by different alters coming through, it can be mistaken for the cycling moods of bipolar disorder.

With severe bipolar disorder, you may have hallucinations, where you see or hear things that arent there. You may also have delusions, where you firmly believe in something that just isnt true. This is when its easy to confuse bipolar disorder for schizophrenia. Some signs that youve got bipolar disorder are:

Its characterized by symptoms of both schizophrenia and symptoms of a mood disorder. This includes mania or depression. The two types of schizoaffective disorder are bipolar and depressive. Episodes of mania occur in the bipolar type. During a manic episode, you may alternate between feeling overly excited to feeling extremely irritable.

How To Prevent Misdiagnosis

Although theres no way to guarantee that a clinician will not misdiagnose or fail to realize a persons mental illness, there are ways to mitigate these risks.

  • Be honest about your symptoms: Many people feel embarrassed and ashamed about their mental health struggles, but theres nothing to be ashamed of. One of the best ways to avoid misdiagnosis is to be completely honest about your symptoms. Providing as much information as possible helps health care providers identify your disorder and mitigates the risk of misdiagnosis.&
  • Record your symptoms, thoughts, and feelings: A great way to help your clinician or health care provider properly identify whether you have a mental illness is by recording your symptoms. Putting your feelings and symptoms on paper can help a clinician better identify any red flags and signs of mental illness.
  • Go to a specialist: There are specialists for every age range, and seeing one that treats patients in your age range increases your chances of receiving an accurate diagnosis. You should also get several opinions before deciding how you want to move forward in treatment.

If you recognize the signs that a loved one needs help with their mental illness, call us now at to learn more about our facility and mental illness treatment in Boca.

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Experience Healing At Hillside

Being diagnosed with a mental health condition is a big deal for kids as well as parents and other authority figures. A diagnosis gives everyone involved an idea of what to expect, and if that idea is wrong, the patient may suffer. At Hillside, we specialize in diagnosing and treating children with a range of treatment needs. We have the clinical expertise to help children heal and develop necessary skills for a healthy life.

Hillside recognizes kids who have behavioral issues need individual attention and a toolkit of strategies to manage their emotions and change their behavior. We understand that kids fit into a family unit, and work to give families the skills they need to support and nurture their children.

Learning to live successfully with a diagnosed mental health condition requires an open and honest relationship with the provider. The better a clinician knows your child, the better they can help the child. Hillside is one of the most trusted names in providing mental health treatment for children and adolescents. We are ready to help and we invite you to contact us to find out more about our services. Call Hillside at 404-875-4551, or fill out our contact form to get in touch and take the first steps toward a correct diagnosis.

690 Courtenay Drive NE,

Review Of International Research On Race And Diagnosis Of Psychotic Disorders

How Scientific Racism Causes Misdiagnosis of Schizophrenia

The vast majority of empirical literature related to race and diagnosis of psychotic disorders has included consumer samples and clinicians from the United States. Nevertheless, could the same diagnostic patterns be found internationally? Alexandre et al reviewed medical records of 977 patients in Portugal, where 82% of the immigrants were from African Portuguese-speaking countries and only 3.3% from Eastern Europe countries. The term Black is widely used in Portugal and refers to patients of African origin while not suggesting any racial prejudice, according to Alexandre et al. Their results showed that Black inpatients where significantly more frequently diagnosed with Schizophrenia and acute and transient psychosis. By contrast, in the Netherlands, Vinkers et al examined 21857 pre-trial psychiatric reports comparing Dutch natives with what they termed Black and minority ethnic groups , and Whites from other Western countries . These researchers found that mandated psychiatric hospital admissions were more frequently recommended for BME persons and Whites from other Western countries compared to Dutch natives .

According to Vinkers et al these findings show how immigrants may encounter an increased risk of psychotic disorders diagnoses and hospital admissions, perhaps related to misunderstanding of or biases about symptomatology.

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