In insidious onset the symptoms are less clear-cut.
Typically a person in late adolescence becomes increasingly withdrawn and introverted. School or work performance deteriorates and the person's drive diminishes. Perhaps, years later it becomes clear that the person is hearing voices or has delusional beliefs.
The main differential in the diagnosis is depressive illness, but, at a stage before the psychotic symptoms are apparent, it may not be at all obvious that the person has a mental illness at all - the symptoms being accounted for by developmental changes.
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