Childhood schizophrenia is one of several types of schizophrenia, a chronic mental illness in which a person loses touch with reality (psychosis). Childhood schizophrenia is essentially the same as schizophrenia in adults, but it occurs early in life — sometimes even before the teen years — and has a profound impact on a child's behavior.
Childhood schizophrenia includes hallucinations; delusions; irrational behavior and thinking; and problems carrying out routine daily tasks, such as bathing. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, educational needs, and emotional and social development.
Identifying and starting treatment for childhood schizophrenia as early as possible may significantly improve your child's long-term outcome.
Early signs and symptoms
Some of these signs and symptoms are also common in children with pervasive developmental disorders, such as autism. In fact, ruling out these developmental disorders is one of the first steps in diagnosing childhood schizophrenia.
Later signs and symptoms
Symptoms may be difficult to interpret
As time goes on, the symptoms may become more severe and more noticeable to family, friends and school officials. Eventually, your child may develop the symptoms of psychosis, including hallucinations, delusions and difficulty with organizing his or her thoughts. As thoughts become more disorganized, there's often a "break from reality." This phase of childhood schizophrenia is often the most distressing to children and their families and frequently results in hospitalization and treatment with medication.
When to see a doctor
If you notice that your child has stopped meeting daily expectations, such as bathing or dressing, no longer wants to socialize, is slipping in academic performance, has violent or aggressive behavior, or has other signs and symptoms of a possible mental health disorder, seek medical advice. These general signs and symptoms don't necessarily mean a child has childhood schizophrenia. They could indicate simply a phase or another condition, such as depression, an anxiety disorder or a medical illness that requires other types of evaluation.
If your child has a change in thinking, such as developing hallucinations, disorganized thinking patterns or distortions in reality, seek medical care as soon as possible, as these symptoms should be addressed right away. Your child's teacher or other school personnel also may bring to your attention changes in your child's behavior.
It's not known what causes childhood schizophrenia, but it's thought that it develops in the same way as adult schizophrenia does. It's not clear why schizophrenia starts so early in life for some, though, and not others.
Childhood schizophrenia and other forms of schizophrenia are brain disorders. Genetics and environment likely both play a role in causing schizophrenia.
Problems with certain naturally occurring brain chemicals called neurotransmitters may contribute to childhood schizophrenia. Imaging studies show differences in the brain structure of people with schizophrenia, but the significance of these changes isn't clear.
Although the precise cause of schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:
Signs and symptoms of schizophrenia typically develop between the teenage years and the mid-30s. Early-onset schizophrenia occurs in children younger than age 17. Very early-onset schizophrenia occurs in children younger than age 13.
Left untreated, childhood schizophrenia can result in severe emotional, behavioral, health, and even legal and financial problems. Complications that childhood schizophrenia may cause or be associated with include:
Preparing for your appointment
You're likely to start by first having your child see his or her pediatrician or family doctor. In some cases when you call to set up an appointment, you may be referred immediately to a specialist, such as a pediatric psychiatrist or other mental health provider who specializes in child development.
In rare cases where safety is an issue, your child may require an emergency evaluation in the emergency room and possibly a hospital specializing in child and adolescent psychiatry.
What you can do
Questions to ask
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions anytime you don't understand something being discussed.
What to expect from your doctor
Tests and diagnosis
If your doctor or mental health provider believes your child may have childhood schizophrenia or another mental illness, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your child's symptoms and check for any related complications.
These exams and tests generally include:
Your child may be evaluated to check his or her ability to think and function at an age-appropriate level. Your doctor may also request to review school records. And your child may be asked to complete psychological questionnaires to help examine his or her mood, anxiety and possible psychotic symptoms.
A difficult and possibly long process
During that time, your child's psychiatrist will monitor your child's behaviors, perceptions and thinking patterns. For example, the psychiatrist will want to know whether problems occur at home or at school, or whether they occur in all environments. In some cases, a psychiatrist may recommend starting treatment with medications even before an official diagnosis is made. This is especially important when symptoms of aggression or self-injury have occurred. Some of the medications can be very helpful in limiting these types of behavior and restoring a sense of normalcy to your child's behavior.
Diagnostic criteria for childhood schizophrenia
The psychiatrist may first diagnose your child with a nonspecific psychotic disorder, rather than schizophrenia. As thinking and behavior patterns and symptoms become more clear over time, a diagnosis of schizophrenia may be made if the criteria are met.
Diagnostic criteria for childhood schizophrenia are generally the same as for adult schizophrenia and include:
Treatments and drugs
Childhood schizophrenia is a chronic condition, lasting through adulthood. Because of this, schizophrenia in children requires lifelong treatment, even during periods when symptoms seem to have subsided. Treatment is similar for all types of schizophrenia, but is a particular challenge for children with schizophrenia.
The team involved in treatment of childhood schizophrenia may include your:
Main treatment options
Medications for childhood schizophrenia
Because of the possibility of serious side effects, make sure you understand all the pros and cons of antipsychotic medication use in children.
Second-generation antipsychotics (atypical antipsychotics)
Atypical antipsychotic medications are often effective at managing such symptoms as hallucinations, delusions, loss of motivation and lack of emotion. Serious side effects can include weight gain, diabetes and high cholesterol and, more rarely, movement disorders.
First-generation antipsychotics (conventional, or typical, antipsychotics)
Typical antipsychotics, especially generic versions, are often cheaper than second-generation antipsychotics. However, their risk of serious side effects means they often aren't recommended for use in children until other options have been tried without success.
Medication side effects and risks
Be sure to talk to your child's doctors about all of the possible side effects and about routine checks for health problems while he or she takes these medications. Also, be alert for problems in your child, and report side effects to the doctor as soon as possible. By spotting medication problems early, your child's doctor may be able to adjust the dosage or change medications and limit side effects. Your child's doctors also can help all of you learn to manage side effects appropriately.
Also, antipsychotic medications can have dangerous interactions with other substances. Tell your child's doctors about all medications and over-the-counter substances he or she takes, including vitamins, minerals and herbal supplements.
Psychotherapy for childhood schizophrenia
Social and academic skills training for childhood schizophrenia
Hospitalization for childhood schizophrenia
Lifestyle and home remedies
Childhood schizophrenia isn't an illness that you or your child can treat on your own. But you can do some things for your family and your child that will build on the professional treatment plan:
Coping and support
Coping with an illness as serious as childhood schizophrenia can be challenging. Medications can have unwanted side effects, and you, your child and your whole family may feel angry or resentful about having to manage a condition that requires lifelong treatment. Here are some ways to cope with childhood schizophrenia:
There's no sure way to prevent childhood schizophrenia. But evidence shows that some signs of schizophrenia may be present as early as infancy. Early identification and treatment may help get symptoms under control before serious complications develop. Avoiding treatment delays may help improve the long-term outlook. Early treatment is also crucial in helping limit psychotic episodes, which can be extremely frightening to a child and his or her parents.
Signs and symptoms during infancy or early childhood years that may warrant further evaluation include:
Getting early treatment — and sticking with it — can help reduce or prevent worsening schizophrenia symptoms.
Last Updated: 2010-12-17
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