Schizophrenia - is there a test?

No clinical schizophrenia test that gives a definite diagnosis has yet been approved. It is therefore not currently possible to go along to your GP or to a hospital to have a simple schizophrenia test that can say whether you have this illness or not. There are some diagnostic tools that can help and research into new schizophrenia tests is ongoing but, for the foreseeable future, diagnosis is likely to depend mainly on observation and opinion.

This article on schizophrenia testing is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites. 

What is schizophrenia?

Schizophrenia is a mental illness that causes a range of different psychotic symptoms such as hallucinations, delusions and disordered thoughts. This can be frightening both for the person affected and for the people he or she is close to. Many people who develop schizophrenia experience problems with emotions, feelings and behaviour. Symptoms can be acute, in some cases lasting only a few weeks, or can be chronic. All of this makes a schizophrenia test a bit of a challenge.

What causes schizophrenia?

The cause of schizophrenia is not yet known, though it is thought to possibly be due to a combination of genetic factors and/or environmental triggers such as brain damage or stressful life events. Until our understanding improves about the exact disease pathways involved, it is difficult to design a very specific schizophrenia test.

Are there any schizophrenia tests being researched?

Several experimental schizophrenia tests have been developed, including urine or blood tests. One group of researchers is also looking at a breath test that can measure the levels of expelled gases related to fat metabolism. This appears to be different in people with this form of mental illness.

Schizophrenia tests like these rely on identifying biological markers that are present in people with schizophrenia but not in ‘healthy’ people. This is very difficult. All the experimental schizophrenia tests need a lot more work yet and need to be validated in large numbers of patients to prove they are useful.

Psychologists and psychiatrists have also researched mental schizophrenia tests such as the Prepulse Inhibition (or PPI) test, which measures the mind's ability to process information.

Schizophrenia tests for screening symptoms

Schizophrenia tests that screen for common symptoms using questionnaires can be helpful in identifying whether a professional opinion is needed, even though they can’t diagnose the condition. It is also important that people with suspected schizophrenia test negative for other illnesses that may have an effect on the brain, such as HIV or epilepsy. Without a definitive clinical schizophrenia test, a firm diagnosis of schizophrenia is usually made based on symptoms, the experiences of the person and the observations of people close to them such as family members.  

What symptoms are assessed during schizophrenia testing?

Without access to a clinical schizophrenia test, psychiatrists tend to diagnose schizophrenia on the basis of the presence of ‘positive’ and ‘negative’ symptoms.

• Positive symptoms show up as abnormal mental functions. In psychological schizophrenia tests, positive symptoms include excessive or distorted everyday behaviour – washing hands dozens of times – and include psychotic symptoms such as delusions, seeing or hearing things that aren’t there, suspiciousness, and disorganised speech, thinking or behaviour. These symptoms are most common in acute schizophrenia.

• Negative symptoms are taken to be the absence of mental functions that healthy people show. In psychological schizophrenia tests, negative symptoms include not being able to speak, being very emotionally unresponsive, showing poor personal grooming and no motivation to do every day things. These signs are more common in chronic schizophrenia.

Not having a schizophrenia test does not help as some of the symptoms are also common in other mental health conditions. They can also be brought on by taking recreational drugs. A firm diagnosis can therefore only be made if symptoms are present for several weeks – which means long delays in treatment. Keeping a journal of symptoms over time can be valuable in providing the information needed for a firm diagnosis to be made in the absence of a clinical schizophrenia test.

Could a schizophrenia test make treatment more effective? 

Following the psychological schizophrenia testing process, schizophrenia treatment options can include medication, ‘talking’ treatments, and social support. The earlier treatment starts and the more support the affected person and their family gets, the better. Having a very reliable, quick and straightforward schizophrenia test would cut down time wasted and save a lot of worry and stress for patients and their families.

There is no cure for schizophrenia but most people benefit from drug treatment to control their psychotic symptoms. However, these drugs can result in unwanted side-effects including muscle stiffening or tremors, sedation, weight gain and restlessness, especially when taken at high doses. Several different types of drugs are available for use in schizophrenia treatment, so it may take a while to establish the best treatment and dose.

Could a schizophrenia test predict treatment success?

At the moment there are no clear ways to predict the schizophrenia treatment options and doses that will provide optimum benefits to each person. As medication may be needed for long periods, it is worth taking the time to find the best treatment, one that provides good benefits with minimum side-effects. If a schizophrenia test could be developed that measured a chemical in the blood that was associated with the level of symptoms, that test could, theoretically, help doctors monitor how effective their treatment was. This may be a long way off yet but, in the next few years, new technology could deliver such a test. Schizophrenia treatment in the meantime will continue to be a matter of ‘wait and see’ with careful support and monitoring.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors.

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