Schizophrenia Simplified for Africans: Types, Causes and Symptoms

Chika Jones BNSC, RN, RM, RPHN. Freelance Health writer and DLHA Volunteer. Medically reviewed by A. Odutola, MBBS, PhD.

Image of a young African male sitting alone and thinking. Image credit: Freepik 

Highlights:

• Schizophrenia is a severe chronic mental disorder that can affect how you feel, think and behave.

• 1 in 300 people worldwide are affected by schizophrenia.

• Men are more affected than women

• People with schizophrenia are likely to die 2-3 times earlier than the general population.

• Culturally driven myths and misinformation on schizophrenia abound in most African communities. These promote profound stigma, discrimination and abuse of human rights of people with schizophrenia.

Introduction 

What is the first thing that comes to your mind when you hear the word “Schizophrenia"? Maybe you've seen it in a movie or read about it in a book but you're still not clear about what schizophrenia means.

This article provides you with a brief and simplified overview of the condition and the importance of understanding its types, causes and symptoms.

What is Schizophrenia?

Schizophrenia was coined from two Greek words “schizen’ (split) and ‘phren’ (mind), suggesting split mind. Split mind is a mental condition where one has two or more different personalities. This is why there is some confusion about schizophrenia and multiple personality disorder (also known as dissociative identity disorder). [1]

Schizophrenia is a severe and chronic mental disorder that can affect how you feel, think and behave. [2] People with schizophrenia are not in touch with reality. They aren't aware if the sounds, sight and touch they experience are real or imagined.

Schizophrenia is one of the top 15 leading causes of disability worldwide. [2] This results from the fact that people affected by the condition find it difficult to return to school, find a job or form stable relationships. 

While precise figures are sparse, schizophrenia is estimated to affect 4 – 5 million people in Africa, with first diagnosis occurring in late teens to early 30’s.  

Risk factors include, male gender, being single, living in urban environment and being a migrant.

Globally, individuals with schizophrenia have an increased risk of dying 15 - 20 years younger compared to the general population. [3] This results from a combination of several factors, including preventable chronic physical conditions such as heart disease, infections and diabetes mellitus as well as homicide, suicides and accidents. [4] Additionally, other contributory factors in Africa particularly, range from inadequacies in quality and access to mental healthcare services, flagrant abuse and glaring maltreatment due to culturally driven myths, misinformation and practices.

Image of a mentally ill African male shackled to a tree and exposed to the elements. Credit: R. Hammond/Panos from: The Adjei Foundation

There is no clear causal relationship between schizophrenia and physical illnesses, but some contributory factors include:

• Drug abuse
• Cigarette smoking 
• Unhealthy living
• Side effects of antipsychotic drugs promoting obesity [5]

Burden of Schizophrenia in Africa

There is limited research on the burden of schizophrenia in Africa generally. This could result from under-diagnosis of the condition, poor access to mental health care generally, lack of awareness of schizophrenia in African communities, poverty and stigma associated with schizophrenia.

Studies have reported that schizophrenia is a major psychiatric disorder that affects about 0.5% of the world’s population. While precise figures are sparse, it has been estimated that between 4 and 5 million individuals afflicted by psychotic disorders live in African countries with first diagnosis occurring in the late teens to early 30’s.  

Risk factors include, male gender, being single, living in urban environment and being a migrant.

Types of Schizophrenia

There are five classical types of schizophrenia that include paranoid, residual, catatonic, disorganised and undifferentiated. Let us discuss them briefly.

• Paranoid Schizophrenia

 This type is common and develops later in life.  It is marked by the individual being suspicious and mistrustful of everyone around them. They think someone wants to harm them without any physical threat or experience. 

• Residual Schizophrenia 

The individual has been diagnosed with schizophrenia but the symptoms have lessened. Most importantly psychotic symptoms such as delusions and hallucinations have reduced.

• Catatonic Schizophrenia

Catatonia is a state of immobility and daze (stupor). It involves lack of movement, communication and mimicking behaviour of others. Catatonic schizophrenia is the rarest type.

• Disorganised 

It was previously referred to as hebephrenic schizophrenia. The symptoms can disrupt a person's thoughts and communication. The individual may have  difficulty in carrying out everyday tasks like eating and personal hygiene, forgetting items, making up words (neologism), not thinking clearly, etc.

• Undifferentiated Schizophrenia 

The individual may experience symptoms of schizophrenia but those symptoms don't fit into any type of schizophrenia that was described above

Causes of Schizophrenia 

Studies are yet to find a single cause of schizophrenia. Based on science, multiple interlinkage between genetics and environment are believed to give rise to the condition [5] However, within many African cultures, the causes of this condition are popularly attributed to curses, demonic agents, spiritual attacks, etc.

Here are some of what we know from science about the causes of schizophrenia:

• Hereditary: Schizophrenia can be passed on to members of the family. If a family member or twins has schizophrenia there is an 80% chance of increased risk among others.

• Pregnancy and Birth complications: Individuals who have experienced complications while in their mother's womb or during delivery have a higher risk of developing schizophrenia. [6] This complications could be:
  • Premature baby
  • Birth asphyxia, i.e. lack of oxygen to the baby during birth 
  • Low birthweight

• Neurotransmitters: These are chemical agents produced by brain cells that serve the purpose of communication between them. It is widely believed that people with schizophrenia may have excessive amounts of certain neurotransmitters in their brain. [7]

• Drug Abuse: Cannabis can worsen psychotic symptoms. There is increased risk of schizophrenia depending when drug abuse started and the amount of drugs taken. [5] .Consistent use of amphetamine, meth-amphetamine and cocaine can cause symptoms similar to paranoid schizophrenia (hallucinations, paranoia). These symptoms can worsen and affect one's life.

• Gender: Men develop schizophrenia more than women. The disorder is severe and has a five years earlier onset in men compared to women. [7]

Symptoms of Schizophrenia 

Schizophrenia affects how people think, feel and behave. 

Key symptoms are described as positive (i.e. due to added experiences) or negative (due to lack of normal function) and they include:

A. Positive symptoms:

• Delusions: This is an inability to understand what is real and unreal or having firm and false beliefs despite evidence to the contrary. 

• Hallucinations: Having sensory experiences that are not real, such as hearing voices or seeing things that aren't there.

• Disorganized Thinking and Speech: Difficulty organizing thoughts and ideas, leading to jumbled or incoherent speech.

• Disorganized or Unusual Motor Behavior: Bizarre or purposeless movements, inappropriate emotional responses, or difficulty with daily activities.

B. Negative symptoms:

• Reduced emotional expression

• Lack of motivation

• Social withdrawal

• Difficulty experiencing pleasure.

• Difficulty with memory, attention, and decision-making (i.e. impairment of cognition). 

Conclusion 

Schizophrenia is a severe and chronic mental disorder that affects thoughts, feelings, and behaviors. Its exact cause is unknown, but a complex interplay of genetic and environmental factors are probably responsible. A clear understanding of its various types and symptoms is useful for getting professional help early for affected individuals. 

References 

1. Avisa by Relevance Recovery. Schizophrenia Vs Multiple Personality: Understanding the Key Difference. [Internet]. Jan 27, 2025 [Cited 2025 Feb 26]. Available from here. 

‌2. National Institute of Mental Health. Schizophrenia [Internet]. Last reviewed Dec. 2024. [Cited 2025 Feb 26]. Available from here.

3. Peritogiannis V, Ninou A, Samakouri M. Mortality in Schizophrenia-Spectrum Disorders: Recent Advances in Understanding and Management. Healthcare (Basel). 2022 Nov 25;10(12):2366. doi: 10.3390/healthcare10122366.  Available from here

‌‌4. World Health Organization. Schizophrenia [Internet]. 2022 Jan. 10. [Cited 2025 Feb. 26]. Available from here. 

‌5. Safiri S, Noori M, Nejadghaderi SA, Shamekh A, Sullman MJM, Collins GS, et al. The burden of schizophrenia in the Middle East and North Africa region, 1990–2019. Scientific Reports. 2024 Apr 27;14(1):9720. doi: 10.1038/s41598-024-59905-8 Available from here. 

‌6. Hany M, Rehman B, Rizvi A, et al. Schizophrenia. [Updated 2024 Feb 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. [Cited 2025 Feb. 26]. Available from here. 

7. NHS. UK. Causes - Schizophrenia [Internet]. Last reviewed April 13, 2023. [Cited 2025 Feb. 26] Available from here. 

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Related: Why Mental Health Matters

Published: May 21, 2025

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