Schizophrenia is a severe mental illness. Most patients have a very slow onset and atypical early presentation, which is easily overlooked by those around them. So, how can schizophrenia be recognized in its early stages? Generally speaking, the following aspects can help in identification. 1. Personality changes and neurotic-like symptoms are the most common manifestations of schizophrenia in the early stages. For example, the patient gradually becomes lonely, incoherent, out of touch, absent-minded, gradually declining in academic performance, irresponsible for work, disinterested, and lazy, requiring supervision even for personal hygiene and daily living. Some patients may talk to themselves or laugh alone for no reason. Many patients complain of dizziness, headache, insomnia, dreaminess, mental depression and general discomfort, and even suspect that they are suffering from some incurable disease. 2. Thought disorders, emotional disorders and disorders of volitional activity are characteristic manifestations of schizophrenia. In the early stages of the disease, minor personality changes and neurotic-like symptoms are often not easily noticed, but careful observation reveals that patients often have strange ideas, and the content of their conversations is often off-topic and very puzzling. Some patients may also experience delusions and hallucinations, and many patients may appear cold, distant, or emotionally unstable and moody. In addition, some patients may sit alone or wander all day and do things that are incomprehensible to others. Once these symptoms are detected, it is very important to diagnose schizophrenia. 3. Patients usually refuse to admit that they are ill, they deny that their performance is pathological, and therefore do not demand treatment urgently, or even refuse it. Even though very few patients may be vaguely aware that they are “sick,” when asked to make a specific analysis, they appear superficial and incomplete, and deny that they have a mental illness. These aspects can be helpful in identifying early schizophrenia. However, sometimes the situation can be more complex for a specific patient and requires careful consultation with a psychiatrist to avoid delays.