It's common for family members, friends, and caregivers of people with schizophrenia to have concerns. Loved ones may worry about safety—the safety of the family member or friend with the disorder, as well as the safety of those around him or her. Because schizophrenia is a serious mental illness, family members and friends also may have concerns about the general health and well-being of loved ones who suffer from the disorder.

Here's some information from the National Institute of Mental Health (NIHM) about common schizophrenia concerns:

Schizophrenia & Violence

According to the NIHM, people with schizophrenia usually are not violent and the risk of violent behavior is small. In those with the disorder who do become violent, the violence often is associated with certain schizophrenia symptoms, such as delusions of persecution (believing one is being harassed, followed, or provoked, or is a victim of a conspiracy) and hallucinations (hearing threatening voices).

Violent behavior in a person with schizophrenia usually is directed at a family member and is most likely to occur at home. Abusing drugs or alcohol increases violent behavior in people with schizophrenia—as well as those without mental illness.

People who have schizophrenia attempt suicide at a much higher rate than those don't have the disorder. About 10 percent of people with schizophrenia commit suicide. The suicide risk is highest in young adult men with schizophrenia. It's important for family members and friends to seek immediate medical attention if a loved one talks about or attempts suicide.

Schizophrenia or Substance Abuse?

Schizophrenia symptoms can be similar to symptoms of drug or alcohol abuse and the disorder sometimes may be confused with substance abuse. Most experts do not think abusing drugs or alcohol causes schizophrenia, but people with the disorder have a much higher risk of substance abuse than the general population.

Certain drugs—including marijuana and stimulants like cocaine or amphetamines—can worsen schizophrenia symptoms. Additionally, substance abuse can interfere with schizophrenia treatment and prevent people who have the disorder from following their treatment plan.

Schizophrenia & Smoking

Smoking is the most common form of substance abuse in people with schizophrenia. The NIMH reports that people who have schizophrenia are addicted to nicotine at the rate of 75 to 90 percent—three times the rate of the general population (about 25 to 30 percent).

The relationship between schizophrenia and smoking is complex and not fully understood. Researchers are trying to determine if biological factors contribute to the need to smoke in people who have the disorder.

Studies show that smoking makes medications used to treat schizophrenia less effective. In addition, nicotine withdrawal may increase symptoms of schizophrenia for a while—making quitting smoking very difficult.

Nicotine replacement therapies may be helpful for people with schizophrenia who are trying to quit smoking. Health care providers who treat people with the disorder should monitor their patient's response to treatment closely if he or she tries to quit.

Source: National Institute of Mental Health (NIMH)

Publication Review By: the Editorial Staff at

Published: 09 Jul 2014

Last Modified: 09 Jul 2014