Complications of untreated schizophrenia may include cognitive challenges and the development of other mental and physical health conditions.
Schizophrenia can affect almost every area of life. Psychosis, or altered reality perception, may lead to significant shifts in behavior and personality. Changes in the brain’s function and structure can, in turn, affect function overall.
Early diagnosis and management of schizophrenia can reduce its effects and prevent complications. However, existing barriers to schizophrenia care could still be a factor, including:
- high costs or no insurance coverage
- lack of access to adequate healthcare
- transportation limitations
- social stigma
- anosognosia (the inability to recognize you are living with a mental health condition)
Cognitive challenges in schizophrenia can also make it difficult to stick to medication schedules or doctors’ appointments. Without consistent symptom management, there’s an increased chance of complications in schizophrenia.
Risks and complications of untreated schizophrenia
The course of schizophrenia can be different for each person. If left untreated, schizophrenia is a progressive condition that may lead to changes in the brain’s structure over time.
There’s no way to predict if schizophrenia symptoms will worsen without treatment, but research suggests untreated schizophrenia typically involves more severe symptoms — both positive and negative.
Positive symptoms, like hallucinations, refer to behaviors or experiences that add to your baseline function. Negative symptoms, like the inability to experience pleasure or express emotions, are those that diminish your baseline function.
Mental complications of schizophrenia
Untreated schizophrenia may lead to changes in the brain’s chemical networks and structure.
According to a 2023 study conducted in China, how long schizophrenia is left untreated directly correlates to an increase in the severity of negative symptoms and a decline in the ability to think.
Negative symptoms of schizophrenia include:
- negative (flat) affect , or reduced emotional expression
- alogia, or decreased speech output
- avolition , or significantly lower motivation and interest in everyday activities
- anhedonia , or diminished ability to experience pleasure
- asociality, or social withdrawal
As the brain changes, other mental health symptoms may develop. These could include :
- difficulty concentrating
- problems recalling information
- trouble learning or retaining new information
- difficulty making decisions
- inability to complete tasks
Other mental health conditions may arise as secondary challenges in schizophrenia. These comorbid (coexisting) conditions can be separate diagnoses. They may be more likely to develop alongside untreated schizophrenia.
Examples of common comorbid mental health challenges in schizophrenia include :
Systematic review and meta-analysis data from 2018 suggests people experiencing psychosis , a common aspect of untreated schizophrenia, have higher rates of suicide and suicide attempts. Hallucinations and delusions are symptoms of psychosis.
Social complications of schizophrenia
Social challenges are common in schizophrenia. Stigma , which is a negative bias around people with a certain characteristic, like a mental health condition, can lead to abrupt changes in social circles after a diagnosis as well as affect work and familial relationships.
Social disconnection is one of the most common social challenges in untreated schizophrenia. It refers to the long-term lack of interpersonal relationships or limited participation in meaningful social activities and interactions.
Over time, changes in behavior and thinking ability, such as diminished memory and concentration, may further affect other social aspects, like education and employment.
Financial hardship or housing instability due to unemployment may also become a challenge with untreated schizophrenia. In turn, relationships can become further strained as stress and added responsibilities stack up.
Physical complications of schizophrenia
Schizophrenia is a mental health condition, but higher rates of long-term physical complications are also associated with it, including :
- cardiovascular disease
- obesity
- metabolic disorders
- infectious conditions
Cognitive, lifestyle, and socioeconomic factors may all play a role.
A 2019 study suggests that people living with symptoms of psychosis were less likely to show proactive health behaviors, like getting regular exercise. They were also more likely to maintain unhelpful habits, like using tobacco.
Overall, people with psychosis reported lower awareness and knowledge about how to prevent diseases and maintain health.
Are complications still possible in managed schizophrenia?
The goal of schizophrenia treatment is to reduce the frequency and severity of symptoms and improve overall quality of life.
Sticking to a treatment plan can reduce the chance of complications, but these may still be possible even if symptoms are managed with medications, psychotherapy, and social support.
Symptom recurrence is also possible. Recurrence is when symptoms flare after they’ve improved. Adverse experiences and stopping medications have been associated with a chance of symptom recurrence.
Stopping medications prematurely or not taking them as directed may lead to complications, even with other supports in place.
A 10-year follow-up study from 2018, for example, found that discontinuing antipsychotic medications during early treatment was linked to an increased chance of suicide attempts.
Some people may also develop treatment-resistant schizophrenia, meaning they continue to experience persistent symptoms even after taking medications for a long time.
Long-term use of antipsychotics may contribute to physical health challenges like cardiovascular disease, but the benefits of schizophrenia treatment often outweigh the risks.
Do schizophrenia symptoms get worse with age?
Age does not predict the severity of schizophrenia symptoms.
Even though schizophrenia is considered a progressive condition, symptoms don’t necessarily intensify as you grow older. But symptoms can change in duration and frequency throughout life. Everyone’s experience is different.
A 2016 review and meta-analysis suggests positive and negative symptoms of schizophrenia may fluctuate as you age, but thinking ability typically worsens as a result of neurodegeneration.
Takeaway
Schizophrenia is a mental health condition that affects almost every aspect of daily life. If left untreated, symptoms may increase in severity and can lead to a variety of other mental, physical, and social challenges.
Successfully managing symptoms with medications, psychotherapy, and support services is possible and may help reduce complications.
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