Symptoms of schizophrenia are prone to various misconceptions and prejudices. One question many uninformed people ask is, “Are people with schizophrenia dangerous?”

Admittedly, schizophrenia is polarizing in nature. Its symptoms are complex and the condition’s elements can be dangerous. However, we guarantee many of these elements are twisted out of proportion.

What is Schizophrenia?

Schizophrenia is a mental health condition that affects your thoughts, feelings, and emotions. More specifically, people with schizophrenia often experience dissociation from reality, leading to many complex symptoms. ¹

These symptoms are not temporary. Schizophrenia is a lifelong condition where treatment largely involves symptom management. If symptoms aren’t managed, it can result in many daily dysfunctions, from relationships to professionalism.

Schizophrenia symptoms have a wide range. Some mimic depression and others involve delusions or hallucinations. With this complexity, symptoms are divided into two categories:

Positive Symptoms

Positive symptoms involve changes in your overall behavior and thoughts. They’re referred to as “positive” because they are easily observable. The most common include: ²

• Confused thoughts
• Delusions
• Hallucinations

Negative Symptoms

These symptoms affect how you experience mood. These often appear similar to other mental health conditions. For example, negative symptoms can lead to loneliness, which may be misconceived as depression. ³

To be diagnosed with schizophrenia, you must present two negative symptoms. ⁴ The most common include: ⁵

• Anxiety
• Depression
• Flat facial emotions (i.e. no reaction or facial recognition to feelings)
• Isolation from friends and loved ones
• Lack of participation in activities you previously enjoyed
• Noticeable changes in communication, sleep, and eating habits

Are People with Schizophrenia Dangerous?

The short answer is no. The fact that those with schizophrenia are more likely to be dangerous or violent is misleading. In reality, those with schizophrenia are as violent or dangerous as anyone else.

However, it can’t be ignored that people with schizophrenia still hold the capacity for violence or dangerous behavior. Therefore, some things loved ones and mental health professionals may want to monitor.

Schizophrenia and Violence

The media often depicts people with schizophrenia as having violent tendencies. However, this is a gross depiction that misrepresents the true struggle of the condition.

Most people with schizophrenia are NOT violent. ⁶ At least, not towards others. It’s much more common for people with schizophrenia to harm themselves.

Admittedly, some people with schizophrenia may act out violently towards others. However, these tendencies are rare. They’re most common in those who struggle with deep psychosis, which is usually a result of a lack of treatment.

Schizophrenia and Sex

Most people with schizophrenia are not sexually active. Research shows they have a lower sex drive than the general population. One of the reasons is schizophrenia medication leads to a decrease in libido. ⁷

There’s a misconception that people with schizophrenia are more likely to commit violent sexual acts, such as rape. However, this belief is not true.

In fact, it’s more common for people with schizophrenia to be victims of a sex crime. This is especially true in women. An average of 40% have reported being taken advantage of. ⁸

Still, some schizophrenia patients do have a healthy libido and may even participate in risky sexual behaviors. Naturally, this can result in other consequences, including: ⁹

• Contraction of sexual diseases, such as HIV ¹⁰
• Lack of communication with a sexual partner
• Rough or unwanted sexual activity

Schizophrenia and Suicide

People with schizophrenia are much more likely to harm themselves than others. In fact, 40 to 79% report suicidal or self-harm tendencies. ¹¹ Furthermore, self-harm is one of the top reasons some may be brought in for an initial diagnosis. ¹²

The earlier a person struggles with schizophrenia, the more likely they are to show self-harm tendencies. Most of the time, these tendencies are an attempt to escape the complications of symptoms. ¹³

The most common self-harm behaviors include: ¹⁴

• Cutting
• Deliberate burning, scratching, or picking of wounds
• Increase in risky behaviors to harm or kill oneself including:
  • Performing dangerous stunts
  • Binge consumption of harmful substances
• Suicidal actions, such as:
  • Deep cutting of the extremities (i.e. major vessels)
  • Hanging
  • Jumping from extreme heights
  • Overdosing on substances

If you or a loved one is at risk of suicide, help is available. In crisis situations, call 911 or go to your local emergency room. In all other cases, you can reach out to the 988 Suicide & Crisis Lifeline.

So, Are People With Schizophrenia Dangerous?

While schizophrenia symptoms may appear dangerous, those with the condition are often only a danger to themselves. As discussed, many make decisions that can lead to consequences, such as:

• Risky sexual behavior
• Self-harm and suicidal ideation
• Substance abuse

Some people with schizophrenia may present physical aggression. However, this is usually the result of a lack of proper treatment.

If you are concerned about yourself or a loved one, speak to your healthcare provider. They will provide you with a treatment path to help curb schizophrenia symptoms.

References

¹ Patel KR, Cherian J, Gohil K, Atkinson D. Schizophrenia: overview and treatment options. P T. 2014 Sep;39(9):638-45. PMID: 25210417; PMCID: PMC4159061.

² Ruiz-Castañeda P, Santiago Molina E, Aguirre Loaiza H, Daza González MT. Positive symptoms of schizophrenia and their relationship with cognitive and emotional executive functions. Cogn Res Princ Implic. 2022 Aug 12;7(1):78. doi: 10.1186/s41235-022-00428-z. PMID: 35960384; PMCID: PMC9374871.

³ Correll CU, Schooler NR. Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. Neuropsychiatr Dis Treat. 2020 Feb 21;16:519-534. doi: 10.2147/NDT.S225643. PMID: 32110026; PMCID: PMC7041437.

⁴ Mosolov SN, Yaltonskaya PA. Primary and Secondary Negative Symptoms in Schizophrenia. Front Psychiatry. 2022 Jan 3;12:766692. doi: 10.3389/fpsyt.2021.766692. PMID: 35046851; PMCID: PMC8761803.

⁵ Mitra S, Mahintamani T, Kavoor AR, Nizamie SH. Negative symptoms in schizophrenia. Ind Psychiatry J. 2016 Jul-Dec;25(2):135-144. doi: 10.4103/ipj.ipj_30_15. PMID: 28659691; PMCID: PMC5479085.

⁶ Wehring HJ, Carpenter WT. Violence and schizophrenia. Schizophr Bull. 2011 Sep;37(5):877-8. doi: 10.1093/schbul/sbr094. PMID: 21860032; PMCID: PMC3160236.

⁷ de Boer MK, Castelein S, Wiersma D, Schoevers RA, Knegtering H. The facts about sexual (Dys)function in schizophrenia: an overview of clinically relevant findings. Schizophr Bull. 2015 May;41(3):674-86. doi: 10.1093/schbul/sbv001. Epub 2015 Feb 25. PMID: 25721311; PMCID: PMC4393701.

⁸ Oram S. Sexual violence and mental health. Epidemiol Psychiatr Sci. 2019 Dec;28(6):592-593. doi: 10.1017/S2045796019000106. Epub 2019 Apr 12. PMID: 30977458; PMCID: PMC6998874.

⁹ Ciocca G, Jannini TB, Ribolsi M, Rossi R, Niolu C, Siracusano A, Jannini EA, Di Lorenzo G. Sexuality in Ultra-High Risk for Psychosis and First-Episode Psychosis. A Systematic Review of Literature. Front Psychiatry. 2021 Oct 27;12:750033. doi: 10.3389/fpsyt.2021.750033. PMID: 34777053; PMCID: PMC8579023.

¹⁰ Negash B, Asmamewu B, Alemu WG. Risky sexual behaviors of schizophrenic patients: a single center study in Ethiopia, 2018. BMC Res Notes. 2019 Sep 27;12(1):635. doi: 10.1186/s13104-019-4673-6. PMID: 31558159; PMCID: PMC6764125.

¹¹ Jakhar K, Beniwal RP, Bhatia T, Deshpande SN. Self-harm and suicide attempts in Schizophrenia. Asian J Psychiatr. 2017 Dec;30:102-106. doi: 10.1016/j.ajp.2017.08.012. Epub 2017 Aug 18. PMID: 28865243; PMCID: PMC5694351.

¹² Hooley JM, Fox KR, Boccagno C. Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives. Neuropsychiatr Dis Treat. 2020 Jan 10;16:101-112. doi: 10.2147/NDT.S198806. PMID: 32021203; PMCID: PMC6959491.

¹³ Falcone T, Mishra L, Carlton E, Lee C, Butler RS, Janigro D, Simon B, Franco K. Suicidal behavior in adolescents with first-episode psychosis. Clin Schizophr Relat Psychoses. 2010 Apr;4(1):34-40. doi: 10.3371/CSRP.4.1.2. PMID: 20643627; PMCID: PMC4001852.

¹⁴ Klonsky ED, Victor SE, Saffer BY. Nonsuicidal self-injury: what we know, and what we need to know. Can J Psychiatry. 2014 Nov;59(11):565-8. doi: 10.1177/070674371405901101. PMID: 25565471; PMCID: PMC4244874.