Schizophrenia: Diagnosis & Therapy

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Schizophrenia: Diagnosis & Therapy
Schizophrenia: Diagnosis & Therapy
Video: Schizophrenia: Diagnosis & Therapy
Video: Schizophrenia - causes, symptoms, diagnosis, treatment & pathology 2023, February

Schizophrenia: Diagnosis & Therapy

Schizophrenia usually runs in episodes. Healthy sections alternate with sick sections. Treatment focuses on drug and psychosocial measures such as psychotherapy and sociotherapy…


  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • Early warning signs
  • Diagnosis of schizophrenia
  • Therapy options
  • forecast
  • What can I do as a relative in a crisis?
  • Whom can I ask?
  • How are the costs going to be covered?

Early warning signs

The actual disease is usually preceded by a stage that sometimes lasts for years, in which changes can already be perceived (prodromal phase). Early symptoms that can indicate schizophrenia include:

  • Poor performance,
  • depressed mood,
  • Nervousness up to overexcitation,
  • Sleep disorders,

  • Concentration and memory disorders
  • Listlessness,
  • social withdrawal,
  • Hearing voices that are imperceptible to others (auditory hallucinations)
  • unusual, incomprehensible thought patterns,
  • feeling persecuted or betrayed
  • Confusion.

Note The symptoms mentioned are very unspecific and can also have other causes. They are less pronounced and more irregular than in the manifest disease. It is therefore important to clarify this with a specialist in psychiatry.

Those affected also have the feeling that they are no longer "who they have always been". The personality changes are also perceived by the social environment. Other symptoms include other forms of hallucinations (e.g. seeing things or people that are not there, smelling imperceptible smells, etc.) or delusions (such as being persecuted, being influenced by outside forces such as aliens and being remotely controlled in thinking, feeling and acting).

Dealing with feelings is usually difficult for those affected. They also find it difficult to understand other people's emotions. Many are ashamed of their symptoms and are afraid of being considered "crazy". Thought disorders can have a massive impact on everyday life. The ability to plan tasks or activities as well as the motivation required for this decrease.

Diagnosis of schizophrenia

The International Classification of Diseases (ICD-10) specifies classification criteria that justify the diagnosis of schizophrenia. Other disorders that are similar to the disorder (e.g., schizotypal personality disorder, transient psychotic disorder, or organic disorders such as the brain) must be excluded. The specialist in psychiatry first conducts an interview in which the medical history (anamnesis) is recorded and the psychological state is examined.

A physical and neurological examination will be performed. If necessary, a psychological test is also carried out. In addition, blood values ​​are determined and a CT or MRI of the brain is performed. If there is a suspicion of an infectious disease that can lead to similar symptoms, further examination methods are used, e.g. special laboratory tests, EEG etc.

Therapy options

The treatment options include above all medication, psychotherapy and sociotherapy. The earlier treatment is started, the better. First-choice drugs are so-called antipsychotics (neuroleptics). Benzodiazepines can also be used as sedatives (only for a short time) and antidepressants. The doctor will explain any side effects. During the drug treatment, regular check-ups are necessary, e.g. weight, motor skills as well as laboratory and blood pressure checks. Psychotherapy also includes psychoeducation (promoting understanding of the disorder and, for example, explaining the relationship to everyday life) as well as behavior change and ideally also includes the family or the social environment.

Sociotherapy is understood as the (re-) learning of social skills, securing basic social needs (such as care, living space, etc.) and rehabilitation - also in the work environment. Other therapy methods such as occupational therapy and physiotherapy can be included.

If treatment in a hospital (inpatient, outpatient or in a day clinic) is necessary, this is done in multi-professional teams (doctors, psychologists, psychiatric nursing service, etc.). In the case of strong states of excitement or danger to oneself or others (e.g. through aggressiveness), emergency measures and possibly judicial detention are necessary.

Psychosocial institutions, such as the psychosocial services, help those affected and their relatives to cope with everyday life and play an important role in health care.

Treating schizophrenia requires a great deal of specialist knowledge and experience. It is often a rocky road, ranging from the difficult diagnosis to the search for the optimal individual therapy. Another important aspect is the motivation of relatives and those affected to participate in the treatment process.


Seventy to eighty percent of all first-time patients recover from the disease within three to six months with early and adequate treatment. Sixty to eighty percent will not relapse if they take antipsychotics as part of long-term treatment. If one or more other mental illnesses (e.g. addiction, depression) are present, the treatment becomes more complex and the prognosis can worsen. Around a third of those affected respond poorly or hardly at all to the therapy and require lifelong medical and social support.

What can I do as a relative in a crisis?

In the event of a psychiatric crisis (complete loss of reality, massive movement disorders, extreme agitation, signs of harm to yourself or others, etc.) or severe side effects from medication, contact the practitioner immediately or, if they are not available, the ambulance at 144 If you recognize a psychiatric crisis, you can read the brochure “Psychiatric crises. Recognize - Treat - Prevent”from the HPE. The attending physician or pharmacist provides information on side effects of medication.

Whom can I ask?

If you suspect you have schizophrenia or would like to help someone close to you, a specialist in psychiatry is your first choice. You can also talk to the general practitioner first. This person then initiates further steps. Specialized child and youth psychiatrists are also available for young people under the age of 18.

Under Services, Links and Brochures you will find helpful information on looking for a doctor or therapist as well as looking for self-help groups (also for relatives).

How are the costs going to be covered?

The costs for the medical examination and treatment are normally covered by the social security agencies. For more information, see Costs and Deductibles and Prescription Fee & Co: This is how drug costs are covered. Information on costs for a hospital stay can be found under What does a hospital stay cost?

A full assumption of costs for psychotherapy is possible in own or contractually bound institutions of the health insurance carriers as well as in institutions that are subsidized by the public purse. In these cases, there is the option of paying a deductible. Otherwise, you have the option of applying for a subsidy from the health insurance company if you are undergoing psychotherapy with a resident psychotherapist. If this is approved, the health insurance provider will reimburse you for part of the fee paid to the psychotherapist. Further information on "Psychotherapy on sickness certificate",You can find subsidies and addresses of resident psychotherapists under Service Search.

The clinical-psychological diagnosis is a service provided by the social insurance institutions. Treatment or advice from resident clinical psychologists, on the other hand, must be paid for privately. There is no reimbursement of costs or grants from the health insurance provider. Treatments and counseling in health or social care facilities or in another publicly financed area (e.g. family counseling centers) can in some cases be used free of charge or at low cost.

Information on rehabilitation can be found under Rehabilitation & Cure.

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