The global number of new schizophrenia cases has risen significantly, climbing from about 883,000 in 1990 to over 1.2 million in 2021. But that headline number is misleading on its own. When researchers adjust for population growth and aging, the actual rate of schizophrenia per person has held roughly steady or even declined slightly, dropping by about 0.04% per year over three decades. The short answer: more people are developing schizophrenia than ever before, but that’s mostly because there are more people on the planet, not because any individual person’s risk has meaningfully changed.
That said, several environmental and social factors are shifting in ways that could push rates higher in specific populations. The story is more complicated than a simple yes or no.
More Cases, but a Stable Underlying Rate
A 2025 analysis of Global Burden of Disease data tracked schizophrenia trends from 1990 to 2021 and projected them forward to 2050. The absolute number of new cases grew by roughly 38% over those three decades. Population growth was the primary driver. More people means more people developing every condition, from diabetes to schizophrenia.
The age-standardized incidence rate, which strips out the effects of population size and age distribution, actually ticked downward over the same period. This is the number epidemiologists care about most when asking whether a disease is truly becoming more common. By that measure, schizophrenia is not on the rise globally. Projections through 2050 suggest the total number of cases will continue climbing before leveling off, again driven largely by demographics rather than a true increase in risk.
How Common Schizophrenia Is Today
The World Health Organization estimates schizophrenia affects roughly 23 million people worldwide, or about 1 in 345 people. In the United States, estimates of schizophrenia and related psychotic disorders range from 0.25% to 0.64% of the population, depending on the study method. A 2024 economic analysis placed the number of U.S. adults living with schizophrenia spectrum disorders at about 3.1 million.
Precise counts are difficult because schizophrenia overlaps with other psychotic disorders, diagnostic methods vary across studies, and many people with schizophrenia never receive a formal diagnosis. The condition typically appears earlier in men, with onset averaging 3 to 4 years sooner than in women.
Cannabis, Cities, and Shifting Risk Factors
Even if the overall rate hasn’t changed much, certain risk factors are becoming more prevalent in ways that matter for specific groups. Two stand out.
High-Potency Cannabis
The link between cannabis and psychosis risk is now well established and dose-dependent: the more you use, and the stronger the product, the higher the risk. High-THC cannabis is particularly concerning for adolescents, whose brains are still developing. Teenagers who use potent cannabis regularly face both an earlier age of onset and more severe psychotic symptoms if they do develop schizophrenia. For people with a family history of psychotic disorders, the risk is amplified further.
Today’s cannabis products are dramatically stronger than what was available a few decades ago, and they’re legal and accessible in more places. This combination of rising potency, wider availability, and limited public education about the specific risks for vulnerable young people creates conditions that could increase schizophrenia diagnoses in certain populations, even if the global baseline rate stays flat.
Urban Living
People raised in densely urban environments are roughly 2.4 times more likely to develop schizophrenia than those in rural areas. This isn’t explained by individual traits like genetics or income alone. Neighborhood-level factors, including social fragmentation (fewer community ties, more isolation) and deprivation, appear to drive the association. As global urbanization continues, more people are exposed to these environmental conditions during the critical developmental years of childhood and adolescence.
Diagnostic Criteria Have Changed
Part of any apparent change in schizophrenia rates reflects how the condition is defined and diagnosed. The most recent edition of the main diagnostic manual used in the U.S. made several notable changes. It eliminated the old subtypes (paranoid, disorganized, catatonic, undifferentiated, and residual schizophrenia) and now requires that at least one of a person’s core symptoms be delusions, hallucinations, or disorganized speech. Under the previous system, someone could technically meet criteria with only disorganized behavior and negative symptoms like emotional flatness.
These changes don’t dramatically widen or narrow who qualifies for a diagnosis, but they do shift the boundaries slightly. Clinicians are also more aware of psychotic disorders than in past decades, and screening tools have improved. Better detection doesn’t mean the condition is more common. It means more people who already have it are being identified.
The Human and Economic Cost
Whether or not the rate is truly rising, the burden of schizophrenia is enormous and growing. People with schizophrenia die an average of 15 to 17 years earlier than the general population, with a mean age at death of about 59. This gap is driven by cardiovascular disease, metabolic conditions, and reduced access to healthcare, not just the psychiatric illness itself.
The economic impact in the United States alone reached an estimated $366.8 billion in 2024, more than doubling from $155.7 billion in 2013. That works out to roughly $119,000 per person per year. Only about 20% of that total comes from direct costs like healthcare, housing support, and interactions with the justice system. The vast majority, nearly $292 billion, reflects indirect costs: lost wages, reduced quality of life, shortened lifespans, and the toll on caregivers. Unpaid caregiving labor alone accounted for $104.6 billion.
These numbers are rising faster than the case count, suggesting that even at stable incidence rates, the societal impact of schizophrenia is intensifying. The gap between what people with schizophrenia need and what systems provide continues to widen, and much of the true cost falls on families rather than healthcare systems.