What is childhood schizophrenia?

Schizophrenia in children is a rare type of schizophrenia, a psychiatric disorder.

Early development of schizophrenia starts at age 13 to 18. Schizophrenia very early on starts before a person reaches the age of 13.

In addition to the starting age, schizophrenia in the childhood is close to adult schizophrenia. Yet the signs may have various effects on children and adults. The effects can be more intense in people who experience them early on in the long term.

In this post, we concentrate on how children are affected by schizophrenia.

Childhood schizophrenia vs. autism

A child with schizophrenia may experience psychosis, delusions, and auditory hallucinations.
A child with schizophrenia may experience psychosis, delusions, and auditory hallucinations.

Several autistic children may have been given a schizophrenia diagnosis wrongly in the past. It remains a struggle to differentiate schizophrenia from the autism and other conditions.

Schizophrenia among children is rare, and some of the symptoms and risk factors may overlap with autism. Moreover, some family and genetic studies have reported differences between autism and schizophrenia in childhood.

As a result, it can take time in some unusual cases for children to get a proper diagnosis of schizophrenia. Doctors are expected to be much faster at diagnosing autism.

Symptoms

Schizophrenia symptoms in children are identical to those in adults, but they can have different implications.

The symptoms include:

  • psychosis
  • delusions
  • auditory hallucinations, in which the child hears voices
  • developmental delays
  • language difficulties
  • difficulty coping with school work and social relationships
  • trouble expressing or recognizing emotions, known as “flat affect”

During social interactions, emotional films, and cartoons, flat effect can be visible. It may also influence another person’s ability to recognise emotions by looking at their face.

Learn more on schizophrenia and its symptoms here.

Unusual characteristics from the early months of life are present in more than half of the children who go on to develop childhood schizophrenia.

The American Academy of Child & Adolescent Psychiatry (AACAP) states that changes will occur gradually over time. Children who have made friends easily or have done well at school before could start finding these things difficult.

The AACAP add that parents and caregivers may notice that their child:

  • has unusual behavior or speech
  • has unusual or bizarre thoughts and ideas
  • confuses television and dreams with reality
  • seems confused in their thinking
  • experiences severe mood changes
  • shows changes in their personality
  • believes that someone is after them or talking about them (paranoia)
  • appears anxious and fearful
  • has difficulty relating to peers and maintaining friendships
  • becomes withdrawn and increasingly isolated
  • neglects their personal grooming

Perhaps the child is not always conscious that their perceptions are different from those of others.

Evidence shows that signs of schizophrenia can be more severe in children than in adults.

How does it feel to a child?

Prof Rochelle Caplan, an expert on schizophrenia in childhood, speaks in the video below about how the signs manifest and the impact they may have. The video was created by the Child Mind Institute, a nonprofit organization.

Prof. Caplan explains how signs in most cases gradually arise. She explains how, for the child at first, the experience can be “very scary.” This may present similar anxiety to parents or carers.

Of example , the child may feel afraid, because the hallucinations or delusions can feel threatening.

The child will also have difficulty paying attention, and may become irritable or may have trouble sleeping. Professor Caplan notes that some of these changes can look like rebellious behavior.

Understanding what the child is feeling will allow the child’s parents and caregivers to respond in a positive way.

Early onset schizophrenia

Early onset schizophrenia is when a child aged 13–18 years is experiencing symptoms of schizophrenia, according to the authors of one case study.

Schizophrenia very early onset is when symptoms appear before age 13.

The researchers identify a child who has had unusual experiences from the age of three months.

There are no separate criteria for differentiating between schizophrenia in childhood and in adult.

Diagnosis

Diagnosis of early onset schizophrenia can be difficult for physicians.

Another reason for this challenge is that it is a rare condition. Many conditions may also cause related habits and symptoms.

Examples may include:

  • depression
  • bipolar disorder
  • personality disorders
  • post-traumatic stress disorder
  • some types of obsessive-compulsive disorder

Autistic children may have characteristics that resemble those of schizophrenia, such as:

  • social withdrawal
  • unusual communication styles
  • avoiding eye contact

There is no specific diagnostic test for the disorder in children as with adult schizophrenia, so diagnosis depends on the exclusion of certain conditions and disorders that may explain the symptoms.

Doctors may use the same criterion for schizophrenia in infancy as for schizophrenia in adults.

Treatment

Children with schizophrenia can receive treatment.

Drugs called antipsychotics help with managing hallucinations, delusions and disorganized thinking. One example is clozapine (Clozaril) but another alternative could be suggested by a health care professional.

Depending on the drug, adverse effects can include:

  • rapid heartbeat
  • sleepiness
  • a low white blood cell count
  • movement side effects
  • weight gain
  • high fat levels in the blood and other metabolic symptoms

Try to take the medications, however, until a doctor changes the prescription. If a person stops taking them then the symptoms will return back.

Schizophrenia is not cured by antipsychotic treatments. In order to manage the symptoms and prevent psychosis the person will need to take medication throughout their lives.

Experts urge families to take an active role in caring for a loved one with schizophrenia and to help them deal with the ongoing difficulties.

Outlook

Schizophrenia is a disease which lasts for life. It can’t be cured or stopped, but therapy will help control it.

If a child has a schizophrenia diagnosis, their family and caregivers can help by learning about the condition as much as they can, by trying to understand how the child feels and by ensuring that they receive ongoing treatment.

Treatment may help many people with the condition go on to work and enjoy fulfilling relationships, depending on the type and severity of the symptoms.

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