The onset of schizophrenia in children and adolescents is polymorphic and can be expressed by an acute psychosis, lucid or confused, by a surprising forensic act, by a depressive episode with or without suicidal ideas and attempts, by a manic episode, by a crisis of juvenile originality, by a neurotic condition, first without apparent dissociative phenomena, or by a hypochondriacal symptoms, dismorfophobia, by depersonalization and derealization phenomena, pathetically experienced by the patient. In this paper, we will present the case of a 37 years old male patient, that was diagnosed with schizophrenia, although the first signs and symptoms appeared at age of 14, but an insidious onset with obsessive-compulsive type manifestations, that had long evolution and were probably underdiagnosed. In schizophrenia, a large number of disabilitative symptoms and maladjusted behaviors appear from the prodromal phase, and highlighting some neurobiological mechanisms have spurred efforts to evaluate the possibilities of intervention even at this stage. If the prodrom could be recognized prospectively and treatment given at this stage, maybe a better evolution would be possible, with an improved long-term prognosis.