Schizophrenia is a brain disorder that affects approximately 1% of the world’s population. It most commonly appears for the first time in the late teens to early twenties. It disrupts the way a person perceives reality, causing a range of symptoms such as auditory hallucinations, delusions, and emotional blunting — but with consistent treatment, a stable daily life is absolutely possible.

The Origin of the Name

Until 2011, the condition was called “jeongsin-bunnyeolbyeong” (정신분열병) in Korean, a term equivalent to “split-mind disease.” To reduce the stigma and social prejudice associated with that name, it was renamed. The current Korean name, “johyeonbyeong” (조현병), uses the word “johyeon” (調絃), which means “to tune the strings of an instrument.” It is a metaphor for a mind that has lost its balance, like a stringed instrument that has gone out of tune.

What Causes Schizophrenia?

No single clear cause has been identified yet. Based on current knowledge, the following factors interact in a complex way.

  • Neurobiological factors: The condition is linked to an overactivation of dopamine, a neurotransmitter in the brain.
  • Genetic factors: Having a family member with schizophrenia increases the likelihood of developing it, but genetics alone do not determine whether the illness will occur.
  • Environmental factors: Severe stress, one’s upbringing, and other environmental conditions can interact with a genetic predisposition to increase the risk of onset.

Main Symptoms

The symptoms of schizophrenia fall into four broad categories.

1. Positive Symptoms

These are “new” symptoms added to a person’s experience — things that do not occur in healthy individuals.

  • Hallucinations: Vividly experiencing sensations that others do not perceive. In schizophrenia, auditory hallucinations (hearing sounds or voices that are not there) are the most common, occurring in more than 90% of patients. The content of these voices varies: a voice that narrates the person’s actions, a voice giving commands, voices using abusive language, or multiple voices in conversation. People experiencing auditory hallucinations often appear to be listening carefully to something, or may be heard muttering to themselves.
  • Delusions: Holding firmly to false beliefs that are clearly disconnected from reality.
  • Disorganised speech and behaviour: Speaking in incoherent or fragmented ways, or displaying catatonic behaviour (a state in which movement and communication become severely slowed or frozen).

2. Negative Symptoms

These involve a reduction or loss of emotions, motivation, and behaviours that are normally present. Because they are not dramatic or obvious, people around the patient often misread them as laziness.

  • Reduced emotional expression, gradually becoming increasingly flat or expressionless
  • Staying in one’s room all day, or cutting off contact with the outside world
  • Difficulty managing basic hygiene such as washing or bathing
  • A marked drop in motivation and interest in activities

3. Cognitive Symptoms

These include difficulties with maintaining concentration, learning new information, memory, and problem-solving. They are not immediately visible, but they are a major barrier to employment and returning to social life.

4. Residual Symptoms

The period after the acute phase (when symptoms are most severe) during which negative symptoms and cognitive difficulties remain is called the residual phase. During this time, combining rehabilitation therapy and cognitive behavioural therapy alongside medication is very helpful.

Changes That May Signal Schizophrenia

If several of the following have been present for a sustained period, it is worth seeking advice from a professional.

  1. Neglecting washing, bathing, or cleaning, and living in an unkempt state
  2. Personal appearance and grooming becoming noticeably more dishevelled than before
  3. Sleep becoming irregular, or day and night reversing
  4. Vague complaints of aches and pains in various parts of the body
  5. Frequently appearing irritable, anxious, or tense over minor things
  6. Pronounced mood swings
  7. Increasing anger and more frequent aggressive behaviour
  8. Difficulty concentrating, leading to an unexplained drop in work performance or academic results
  9. Becoming excessively absorbed in philosophical or religious topics, or talking frequently about death and suicide
  10. Spending more and more time alone and avoiding being with others
  11. Talking less, and often appearing to be deeply lost in thought

Diagnostic Criteria

Schizophrenia is diagnosed when all three of the following criteria are met.

Characteristic Symptoms (at least 2 of the following, present for a significant portion of a one-month period)

  • Delusions
  • Hallucinations (auditory, visual, tactile, etc.)
  • Disorganised speech that is difficult to follow
  • Disorganised or catatonic behaviour
  • Negative symptoms (reduced emotional expression or loss of motivation)

Decline in Social or Occupational Functioning

After the onset of illness, the person’s level of functioning in major areas of life — work, interpersonal relationships, and self-care — must be markedly lower than it was before the illness began.

Duration

Signs of the disturbance must persist for at least 6 months, and for at least 1 month within that period the characteristic symptoms listed above must be clearly present.

Treatment

Schizophrenia is a treatable condition. Please do not worry. With appropriate treatment, many people are able to return to a stable daily life.

Medication

Antipsychotic medication is the most central form of treatment. It usually takes at least 6 to 8 weeks at an adequate dose to find the right medication for an individual. In recent years, second-generation antipsychotics — which offer better effectiveness and fewer side effects — have become available, as have long-acting injectable formulations that continue working for one month or more after a single injection. Continuing to take medication consistently after symptoms improve is very important for preventing relapse.

Psychosocial Treatment

Combining the following with medication can lead to even better outcomes.

  • Psychotherapy (psychological counselling): Helps the person understand their symptoms and learn ways to cope with them.
  • Rehabilitation therapy: Supports recovery of daily living skills, vocational abilities, and other practical capacities.
  • Cognitive behavioural therapy: Effective for identifying and correcting unhelpful thinking patterns. Additional explanation of cognitive behavioural therapy can be found in Anxiety Disorder Symptoms and Treatment, Mental Health Counselling Guide for Foreigners.
  • Family education: Education that helps family members understand schizophrenia accurately and support the person with the condition.

Inpatient Treatment

Hospital admission is considered in the following circumstances.

  • When there is a risk of behaviour that is dangerous to the person themselves or to others
  • When serious medication-related side effects occur
  • When basic daily functioning is no longer possible

Course and Prognosis

The course of schizophrenia varies greatly from person to person.

  • Approximately 10 to 20% of patients have a relatively good outcome.
  • Approximately 20 to 30% are able to maintain a reasonably normal daily life.
  • Approximately 50% experience recurring symptoms and a more chronic course.

In cases of relapse, it is important to seek medical attention quickly when prodromal symptoms — the subtle changes that appear before more pronounced symptoms emerge — begin to show.

Frequently Asked Questions

Q. Is schizophrenia hereditary? There is indeed a genetic tendency. However, having a genetic predisposition does not mean the illness will definitely develop. The likelihood of onset increases when multiple factors — including environmental stress — act together.

Q. Can the person with schizophrenia recognise their own symptoms? Sometimes yes, but often no. When a person has no awareness that changes are happening to them, this is described as having “no insight.” In such cases, support from the people around them is absolutely essential.

Q. Are people with schizophrenia dangerous? This is a common misconception. The great majority of patients are not dangerous; in fact, they are often the ones who feel frightened — particularly due to paranoid thinking — and become isolated from society. It is very rare for patients who are receiving consistent medication treatment to show violent behaviour.

Q. Can schizophrenia be prevented? No method of preventing the illness from developing is currently known. However, it is clear that seeking professional help quickly when early symptoms appear leads to a significantly better outcome.

How to Get Help in Korea

Even if you have just arrived in Korea, there is no need to worry. Help is available through the organisations below.

  • Mental Health Crisis Counselling Line: 1577-0199 (24 hours, free) — You can find your nearest centre at the Ministry of Health and Welfare Mental Health Welfare Centre page.
  • Suicide Prevention Counselling Line: 109 (24 hours, free) — From January 2024, the former three-digit emergency number 1393 was merged into the single emergency number 109.
  • Health and Welfare Counselling Centre: 129 (24 hours, free) — Provides guidance and referrals for mental health-related services.
  • Local Mental Health Welfare Centres: Located in every region across the country, offering counselling, case management, and rehabilitation programmes free of charge. Foreign residents are welcome to use them. You can find the centre responsible for your area on the Ministry of Health and Welfare Mental Health Policy page.
  • National Health Information Portal (Korea Disease Control and Prevention Agency): Verified medical information about schizophrenia and many other conditions is available in Korean at health.kdca.go.kr.

Phone numbers and operating arrangements can change, so please confirm the latest information with the Immigration Contact Center (1345) or your local Korea Immigration Service office before making contact.

Specific details about treatment costs and support programmes may differ between organisations, so it is a good idea to contact the relevant organisation before visiting.