Latent schizophrenia develops in middle age, with symptoms such as hallucinations and social isolation. There are treatment options and ways to cope.

Schizophrenia usually develops in someone’s late teens until their early 30s.

But about 20% of people with schizophrenia don’t experience symptoms until middle age, between ages 40 and 60. This is known as latent schizophrenia or late-onset schizophrenia.

People with latent schizophrenia are more likely to experience symptoms such as hallucinations, hearing voices, and delusions of grandeur. They’re less likely to have the psychotic episodes that younger people with schizophrenia experience.

Researchers believe both genetic and environmental factors play a role in the development of latent schizophrenia.

Latent schizophrenia is a form of schizophrenia that develops between the ages of 40 and 60. The condition develops without the episodes of psychosis that characterize other forms of schizophrenia.

Schizophrenia affects about 1% of people in the United States. About a fifth of people with schizophrenia have a late-onset version of the condition.

Latent schizophrenia doesn’t have its own entry in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). But some experts propose it should be considered a subtype of schizophrenia.

The condition tends to affect females more than males. Symptoms tend to be more internalized and less outward-facing.

Genetic studies, like this 2020 study, conducted in the last decade show that rare variations within chromosomes, particularly in the X sex chromosome, may contribute to the development of latent schizophrenia.

People with latent schizophrenia experience the characteristic symptoms of schizophrenia, such as:

  • hallucinations
  • delusions of grandeur
  • social isolation
  • trouble with concentration and focus

But people with latent schizophrenia usually don’t present episodes of psychosis that younger people with the condition may experience.

A recent study found that most people with latent schizophrenia lose a sense of their mental age. They regress into childlike behavior and believe that they’ve lost the independence and responsibility that comes with adulthood, the study says.

Nearly half the people with latent schizophrenia in the study said they’d always felt both younger and more defenseless than their peers from a young age.

There’s no single cause of latent schizophrenia, according to a 2006 study. Rather, researchers believe that a mix of genetic and environmental factors contribute to the development of latent schizophrenia.

A 2022 study suggests that the cellular changes that contribute to schizophrenia begin as young as infancy or even in utero. But that they happen so slowly that symptoms don’t present for 20 years or more.

A 2006 study suggests a mother’s exposure to influenza while pregnant, particularly during the second trimester, may increase the likelihood of a child developing schizophrenia later in life.

There’s research that suggests an anomaly on the X chromosome contributes to the development of schizophrenia. The authors note that more research and improved genetic screening are needed for conclusive evidence of that connection.

People with late-onset schizophrenia are more likely to be female, have a history of familial trauma, and have less formal education than those whose illness begins earlier, according to a 2014 study.

In 2015, scientists with the Psychiatric Genetics Consortium identified 108 markers where the DNA of people with schizophrenia differs from that of people without schizophrenia.

Up to a third of people living with schizophrenia may have a rare genetic variation that contributes to the development of the condition.

Other research suggests there may be a link between inflammatory conditions, such as autoimmune diseases and infections, and late-onset schizophrenia. According to a 2014 study, these conditions could trigger the onset of schizophrenia.

Schizophrenia usually sets in during late adolescence or early adulthood.

The condition can occur in males and females. Males usually develop symptoms in their late teens and early 20s, while females present symptoms in their late 20s and early 30s.

The average age for the appearance of schizophrenia symptoms is between 13.78 and 29.28 years, according to a 2020 study.

Schizophrenia, in some cases, can be dormant and not surface until triggered by something.

The triggers may be emotional, such as trauma resurfacing, or circumstantial, such as a chronic illness or an autoimmune disease that appears suddenly.

Antipsychotic medications

Antipsychotics are the traditional treatment for schizophrenia, but most clinical trials of these medications were conducted on people whose schizophrenia developed in adolescence or early adulthood.

Because of this, some research says that antipsychotics may be neither as safe nor as effective on people with latent schizophrenia, and that lower doses than usual must be used on older patients.

Antipsychotics may be helpful in the short-term to stabilize someone whose schizophrenia does begin later in life, however.

Cognitive behavioral social skills training (CBSST)

CBSST, which combines cognitive behavioral therapy (CBT) and techniques on social skills training, may be effective for older adults with latent schizophrenia.

People with late-onset schizophrenia may present childlike behavior and a sense of loss of independence. CBT can help them identify, understand, and refocus the thought patterns associated with the condition.

There are other ways you can manage symptoms of late-onset schizophrenia, including support groups and stress-relieving techniques. Support groups and treatment are also available for family members or caregivers of those living with latent schizophrenia.

You can learn more about treatment options for schizophrenia.

The exact reasons why schizophrenia may present in adolescence for some and middle age for others is unknown.

Latent schizophrenia, or late-onset schizophrenia, occurs in one-fifth of people with schizophrenia.

Symptoms of late-onset schizophrenia usually develop between ages 40–60. Researchers believe genetic and environmental factors play a role in the development of the condition.

People with latent schizophrenia may experience hallucinations, social isolation, and trouble focusing. They rarely experience episodes of psychosis, which is one of the symptoms younger people with schizophrenia experience.

Although there’s no cure for schizophrenia, symptoms of latent schizophrenia are manageable. Treatment includes medication and therapy, as well as support groups and self-care techniques.

To learn more about this condition, you can check out Psych Central’s hub for schizophrenia.

If you’re looking for a therapist but aren’t sure where to start, you can check out Psych Central’s guide to finding mental health support.