What Is a Schizophrenia Test?

Schizophrenia is a serious mental illness causing difficulty in managing emotions and making decisions, the inability to think clearly, and trouble relating and interacting with other people.

Sometimes referred to as paranoid schizophrenia, diagnosing the condition is no easy undertaking. There isn’t a schizophrenia test that can be used for a definitive diagnosis. Also, several other mental illnesses can mimic the symptoms of schizophrenia, and other factors (such as methamphetamine or LSD drug use) may cause schizophrenic-like symptoms.

Another obstacle to overcome in the diagnostic process is the denial that many people with schizophrenia develop, not believing that they have the disease. This lack of awareness lends itself to complicating the diagnostic process as well as subsequent treatment efforts. 

This article discusses testing for schizophrenia. It also includes a self-assessment test that can help lead you to a clinical diagnosis.

schizophrenia test

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At What Age Does Schizophrenia Typically Develop?

Schizophrenia normally develops at different times for men and women:

  • Men: During the late teens to the early 20s
  • Women: During the late 20s to early 30s

Although schizophrenia can occur at any age, it is unusual for the condition to be diagnosed in someone under age 12 or over age 40.


A number of online self-assessment tools are available that can help a person determine whether symptoms are present similar to those of a person with schizophrenia. The information gathered from a self-assessment quiz may help a person decide whether to seek medical attention. 

You can find one self-assessment tool at Mental Health America. Examples of questions on this self-evaluation include:

  • Have you felt that you are not in control of your ideas or thoughts?
  • Do familiar surroundings sometimes seem strange, confusing, threatening, or unreal to you?
  • Do you struggle to trust that what you are thinking is real?
  • Do you struggle to keep up with daily living tasks such as showering, changing clothes, paying bills, cleaning, cooking, etc.?

The tool includes additional varied experiences common to those of people diagnosed with schizophrenia, allowing an individual to determine if similar experiences have occurred for them.

Self-Assessment Should Not Replace a Medical Screening

Using a self-assessment tool is not a replacement for seeing a mental health professional. If you suspect you could have schizophrenia, it is important to receive a medical screening.

Symptoms of Schizophrenia

The symptoms of schizophrenia may differ, depending on the stage of the disorder. Diagnosis can be more challenging during certain stages as well as at specific ages.

For example, when a person is in the early stage of the condition—called the prodromal stage—during adolescence, symptoms may mimic common adolescent behavior. The first signs of schizophrenia may be symptoms such as:

  • Sleep problems
  • A decrease in performance (such as a drop in grades)
  • A sudden change in a person’s social or friends’ group
  • Withdrawal or isolation

Unfortunately, these early symptoms can also be normal developmental hurdles that an adolescent goes through. This factor is one of several that complicate the diagnosis process.

In addition to a decline in functioning that must be present for at least six months, common symptoms that are observed when a person has schizophrenia include:

  • Hallucinations: Hearing voices, seeing things, or smelling things that others do not perceive. Auditory hallucinations (hearing voices) and visual hallucinations (seeing people or other things that do not exist) appear very real to a person with schizophrenia.
  • Delusions: False beliefs that a person resolutely holds onto regardless of evidence to the contrary
  • Disorganized thinking: Talking in a jumbled, nonsensical way, starting a conversation in the middle of a sentence, or otherwise saying things that are nonsensical to others 
  • Disorganized or abnormal behavior: A symptom that may exhibit itself in a few different ways, from acting unpredictably to agitation, bizarre posture, a total lack of response, or excessive physical movements
  • Negative symptoms: Symptoms of schizophrenia that represent a lack of normal behaviors, such as those that enable a person to experience enjoyment

Examples of negative symptoms of schizophrenia include:

  • Lack of emotion
  • Blunted expression
  • Speech that appears dull
  • Poor hygiene
  • Lack of energy and enthusiasm
  • Social isolation
  • Difficulty concentrating
  • A decreased interest in work, school, goals, and other activities
  • Insomnia
  • Cognitive impairment, including trouble remembering, learning, concentrating, organizing thoughts, completing tasks, and making decisions

The negative symptoms of schizophrenia often begin several years before the person experiences the first psychotic episode. Psychotic episodes (the active stage) begin during the second stage of the disease.

The Stages of Schizophrenia

The stages of schizophrenia include:

  • Prodromal stage: This marks when the initial decline in functioning begins and may involve mild symptoms. If an exam is performed during this stage, a definitive diagnosis will not be made unless/until the symptoms become clearer.
  • Active stage: Also known as acute schizophrenia, this stage involves severe symptoms of psychosis such as delusions and hallucinations. This is the period when most people with schizophrenia seek medical intervention and are diagnosed with the disorder.
  • Residual stage: This is the period after initial treatment is implemented. During the residual stage, a person with schizophrenia may not have any symptoms of psychosis and the negative symptoms may be the only “residual” signs of the disorder.

Medical Screening 

A diagnosis of schizophrenia involves:

  • A history and physical (H&P): Includes a physical examination and the person’s medical and family history
  • A verbal interview: To evaluate any experiences or perceptions that may be disturbing and assess the person’s concerns about the level of functioning (such as life goals, motivation, and cognition) as well as their psychiatric history
  • A safety evaluation: To decipher whether the person has any thoughts of suicide or has formulated any plan of self-harm, in addition to assessing if any other psychiatric symptoms might put someone at risk

Schizophrenia Tests

Although there is no specific lab test to diagnose schizophrenia, many types of medical tests are performed to help evaluate signs and symptoms of schizophrenia, while ruling out other disorders.

Imaging tests may be employed to help rule out other causes of symptoms. These can include:

  • MRI scan: An image of the brain may be taken to rule out an organic (physical) abnormality that may be causing symptoms similar to those in the diagnosis of schizophrenia.
  • CT scan: This may be done to look for structural findings (such as a brain tumor) that could be the underlying cause of schizophrenia-like symptoms.

Other tests to rule out causes of schizophrenia-like symptoms may include:

  • Blood test: This can be used to rule out other underlying causes of schizophrenia-like symptoms such as alcohol or drug abuse or interactions between specific types of prescription medications or metabolic abnormalities.
  • Cognitive tests: These tests screen a person for problems with cognition that are often seen in people with schizophrenia but can also occur due to other underlying causes of cognitive impairment (such as Alzheimer’s disease, depression, side effects of medications, and more). Cognitive impairment could be mild to severe: it involves difficulty with memory, language, judgment, and the ability to learn new things.

Although cognitive problems have long been noted as a central component of schizophrenia, cognitive impairment has only recently been considered a common symptom of the condition. Almost all people diagnosed with schizophrenia have some type of cognitive impairment, ranging from mild to severe.

Although cognitive impairment is mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it has not yet been included as part of the diagnostic criteria.

Ruling Out Medical Causes

If a medical doctor performs medical tests and is unable to find a physical cause for the symptoms a person is experiencing, a referral may be made to a mental health professional—such as a psychiatrist or psychologist—to perform a mental illness diagnosis.

Psychological Evaluation

A psychological evaluation is a diagnostic assessment that includes looking at a person’s abilities, behavior, and many other characteristics. The evaluation is used to gather many different aspects of a person’s history, symptoms, concerns, and more. It is aimed at making a mental health diagnosis.

Diverse psychiatric data is gathered during a psychological evaluation, including information about:

  • The presence of signs and symptoms of psychiatric disorders, such as anxiety, substance use, depression, and other disorders
  • Nonpsychiatric issues, such as goals, career interests, intelligence level, and more

The psychological exam may gather information using a wide range of diagnostic tools, including:

  • Interviews
  • Self-reports
  • Standardized tests
  • Psychological measurement devices
  • Self-reports
  • Other specialized procedures

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Criteria

The DSM-5 is considered the standard reference book in mental illness diagnoses (including schizophrenia). It is published by the American Psychiatric Association.

According to the DSM-5, before a diagnosis of schizophrenia can be made, a person must have two or more of the following symptoms in the past 30 days (as well as having other signs of the disturbance for at least the past six months):

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms

In addition to the requirement of having at least two of the symptoms on the list to be diagnosed with schizophrenia, at least one of the symptoms must be a symptom of psychosis (including delusions, hallucinations, or disorganized speech).

After medical tests are performed to rule out other possible causes of symptoms of schizophrenia, the diagnostician determines whether the person’s symptoms are such that they qualify for a diagnosis of schizophrenia, according to these criteria outlined by the DSM-5.

What Is Paranoid Schizophrenia?

Paranoid schizophrenia is a term no longer used in the medical community. In 1993, the American Psychiatric Association removed paranoid schizophrenia from the DSM-5. This is because the APA determined paranoia is a key feature of schizophrenia and not a separate condition. 

Other Related Conditions

During a psychological evaluation, a person with symptoms of schizophrenia may be found to have other types of mental illness that could cause similar symptoms such as:

  • Brief psychotic disorder: An episode of psychotic symptoms lasting less than 30 days
  • Delusional disorder: Experiencing some type of delusion, such as having a delusion of grandeur without other accompanying symptoms
  • Schizoaffective disorder: Symptoms of psychosis, along with a mood disorder
  • Schizophreniform disorder: A psychotic disorder, similar to schizophrenia, but the symptoms only last one to six months
  • Schizotypal personality disorder: A condition involving an ongoing pattern of social and interpersonal deficits, often marked by eccentricities and thought distortions

A Word From Verywell

It’s important to realize that an early diagnosis is said to improve the outcome of schizophrenia.

According to the National Mental Health Alliance (NAMI), the role of psychotropic medication (drugs that treat symptoms of mental illness) for early treatment is evolving, but psychotherapy and psychosocial intervention are an absolute must.

Frequently Asked Questions

  • What are the early warning signs of schizophrenia?

    Early warning signs of schizophrenia include: 

    • Anxiety
    • Depression
    • Diminished self-confidence
    • Low energy levels
    • Nervousness
    • Restlessness
    • A severe decline in work or school performance
    • Social withdrawal
    • Trouble concentrating
    • Unclear thinking
  • What are the four types of schizophrenia?

    Schizophrenia presents differently from one person to the next, but there are four main subtypes of the condition. These include: 

    • Catatonic schizophrenia
    • Paranoid schizophrenia
    • Schizoaffective disorder
    • Undifferentiated schizophrenia 
  • What triggers paranoid schizophrenia?

    The exact cause of schizophrenia with paranoia isn't clear. Factors associated with developing schizophrenia include genetics, brain chemistry, and environmental factors. 

    Having a family history of schizophrenia, exposure to toxins in utero, complications at birth that impact brain development, or taking mind-altering drugs during young adulthood are associated with an increased risk of schizophrenia. 

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Association for Mental Illness (NAMI). Schizophrenia.

  2. Gould F, McGuire LS, Durand D, et al. Self-assessment in schizophrenia: accuracy of evaluation of cognition and everyday functioningNeuropsychology. 2015;29(5):675-682. doi:10.1037/neu0000175

  3. Mental Health America. Psychosis test.

  4. Cleveland Clinic. Schizophrenia.

  5. NYU Langone Health. Diagnosing schizophrenia.

  6. MedlinePlus. Cognitive testing.

  7. Davidson M. Cognitive impairment as a diagnostic criterion and treatment target in schizophrenia. World Psychiatry. 2019;18(2):171-172. doi:10.1002/wps.20651 

  8. American Psychological Association. Psychological assessment.

  9. Cleveland Clinic. Schizophrenia.

  10. Cleveland Clinic. What are the 4 types of schizophrenia and how do they affect you?

  11. Mayo Clinic. Schizophrenia.

By Sherry Christiansen
Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research.