Childhood schizophrenia is a severe brain disorder in which children interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), behavior or emotions. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behavior. Signs and symptoms may vary, but they reflect an impaired ability to function.
Childhood schizophrenia is essentially the same as schizophrenia in adults, but it occurs early in life and has a profound impact on a child's behavior and development. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, educational needs, and emotional and social development.
Schizophrenia requires lifelong treatment. Identifying and starting treatment for childhood schizophrenia as early as possible may significantly improve your child's long-term outcome.
The earliest indications of childhood schizophrenia may include developmental problems, such as:
Some of these signs and symptoms are also common in children with pervasive developmental disorders, such as autism spectrum disorders. So ruling out these developmental disorders is one of the first steps in diagnosis.
Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be harder to recognize. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as:
Compared with adults, teens may be:
As children with schizophrenia age, more typical signs and symptoms of the disorder begin to appear. Signs and symptoms may include:
When childhood schizophrenia begins early in life, symptoms may build up gradually. The early signs and symptoms may be so vague that you can't recognize what's wrong, or you may attribute them to a developmental phase.
As time goes on, symptoms may become more severe and more noticeable. Eventually, your child may develop the symptoms of psychosis, including hallucinations, delusions and difficulty organizing thoughts. As thoughts become more disorganized, there's often a "break from reality," frequently resulting in hospitalization and treatment with medication.
It can be difficult to know how to handle vague behavioral changes in your child. You may be afraid of rushing to conclusions that label your child with a mental illness. But early treatment will likely help in the long run. Your child's teacher or other school staff may alert you to changes in your child's behavior.
Seek medical advice if your child:
These general signs and symptoms don't necessarily mean your 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.
Seek medical care as soon as possible if your child has a change in thinking, as these symptoms should be addressed right away. Signs and symptoms can include:
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 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.
If schizophrenia is suspected, your child's doctor typically asks about medical and psychiatric history, conducts a physical exam, and does medical and psychological screenings. Your doctor may also request to review school records. This process can help pinpoint a diagnosis and rule out other problems that could be causing your child's symptoms.
The diagnostic process generally involves:
The path to diagnosing childhood schizophrenia can sometimes be long and challenging. In part, this is because so many other conditions can have similar symptoms, such as depression or bipolar disorder. A child psychiatrist may want to monitor your child's behaviors, perceptions and thinking patterns for six months or more.
For example, the psychiatrist will want to know whether problems occur only at home or at school, or everywhere. In some cases, a psychiatrist may recommend starting medications before an official diagnosis is made. This is especially important for symptoms of aggression or self-injury. Some medications can help limit these types of behavior and restore a sense of normalcy.
To be diagnosed with childhood schizophrenia, your child must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
The psychiatrist may first diagnose your child with a nonspecific psychotic disorder. As thinking and behavior patterns and symptoms become clearer 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. This involves ruling out other mental health disorders and determining that symptoms aren't due to substance abuse, medication or a medical condition.
A person must have at least two of the following signs and symptoms most of the time during a one-month period, with some level of disturbance being present over six months:
At least one of the symptoms must be hallucinations, delusions or disorganized speech.
The person shows a significant decrease in the ability to attend school, work or perform normal daily tasks most of the time.
Left untreated, childhood schizophrenia can result in severe emotional, behavioral and health problems. Complications associated with schizophrenia may occur in childhood or later, such as:
Early identification and treatment may help get symptoms of childhood schizophrenia under control before serious complications develop. Early treatment is also crucial in helping limit psychotic episodes, which can be extremely frightening to a child and his or her parents. Avoid treatment delays to help improve your child's long-term outlook.
Although childhood schizophrenia requires professional treatment, here are ways to get the most out of the treatment plan:
Coping with 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. To help cope with childhood schizophrenia:
Although the precise cause of schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:
Schizophrenia symptoms generally start in the late teens to the mid-30s. It's uncommon for children to be diagnosed with schizophrenia. Early-onset schizophrenia occurs in children younger than age 17. Very early-onset schizophrenia in children younger than age 13 is rare.