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As a result of their illness, patients with schizophrenia experience difficulties in many dimensions of their daily life, including:

• Functioning at work
• Performance in school or academic setting
• Daily living activities
• Parenting
• Self-care
• Independent living
• Leisure time activities
• Interpersonal relationships

In addition, other challenges faced by patients with schizophrenia include:

• Increased risk of substance abuse (alcohol and drugs)
• Higher risk of infectious diseases
• Post-Traumatic Stress Disorder (PTSD)
• Homelessness
• Victimizing other people (e.g., assault)
• Smoking-related illness
• Anxiety
• Depression
• Hostility
• Increased mortality from suicide, accidents, and illness

The impact of schizophrenia on quality of life is significant since symptoms can be so disruptive for the patient and for others close to them. For example, patients with schizophrenia may not make sense when they speak or they may make sense until they describe what they are thinking about. This can lead to isolation from family and other social contacts which may further exacerbate the symptoms. In addition, many people with schizophrenia suffer from depression and/or substance abuse - both of which elevate the risk of suicide. Further impact is noted in difficulties with employment, pursuing goals such as finishing education, forming relationships, and living an independent, meaningful life.

Fortunately, the majority of patients with schizophrenia are responsive to a specific class of medication known as antipsychotics. In addition, evidence strongly suggests that they also benefit from psychosocial education which helps the patients and their families cope with the myriad of problems they face and also aids their reintegration into society and into some type of employment, whether it is competitive or in a sheltered setting special for patients with mental illness. Unfortunately, schizophrenic patients often resist treatment and/or are noncompliant with therapy since they lack the awareness that they have a mental disorder and they believe their hallucinations or delusions are real. As a result, the family may only be able to get help for the patient if a crisis occurs or if the patient becomes dangerous to themselves or to others and may need to be hospitalized (voluntarily or not) with the help of the police.

The greatest challenge in managing schizophrenia once the patient has been treated is improving daily functioning at every level, including:

• Re-entering the work force - most schizophrenic patients want to work, although it is estimated that only 10-20% enter the competitive work force
• Reversing dysfunctional social relationships - schizophrenic patients have few friends and lack the tools for conflict resolution.
• Combating ignorance about their condition, treatment, and challenges
• Overcoming stigma among acquaintances, strangers, and coworkers

As progress in the diagnosis and treatment of schizophrenia has evolved and continues to be vigorously investigated, an emphasis is being made on identifying and treating symptoms as early as possible - either during the prodromal stage or with the first appearance of psychotic symptoms. This is based on evidence that psychosis takes longer to respond to medication if not initiated early in the episode. In addition, the level of impairment of the patient with schizophrenia is closely associated with their level of socialization at the time of onset - so that the younger the patient at onset, the impact of schizophrenia is more severe. Early intervention during the prodromal stage may delay the age at which the first psychotic episode takes place, thus potentially improving the long-term prognosis for the patient.