Schizophrenia in Children
Typical Adult Schizophrenia Symptoms
In adults, schizophrenia is widely recognized for its ability to produce two profoundly life-altering symptoms: hallucinations and delusional, often paranoid patterns of thought. Doctors group these two indicators, known together as psychosis, into a larger category known as “positive” signs of schizophrenia. (This term has a specific medical definition, and does not mean positive in the common sense of the word.) Other symptoms in this category include disjointed or disordered thinking and jittery, pointless body movement.
There are two other schizophrenia symptom categories, known as “negative” symptoms and cognitive symptoms. Common negative signs include:
- A reduced or absent ability to feel pleasure
- A drop in verbal communication
- A lack of facial or vocal expression/emotion
Common cognitive signs include:
- A reduced ability to pay attention or focus
- Disruptions in a form of short-term memory called working memory
- A poor ability to make logical decisions or judgments
Teenagers with schizophrenia also experience many of the same symptoms. In addition, they may develop other indicators such as:
- Sleeping difficulties
- Declining academic performance
- Participation in drug or alcohol use
- Disconnection/withdrawal from loved ones or friends
- A depressed or down mood
- A lack of drive or initiative
Differences in Childhood Schizophrenia
When schizophrenia affects people under the age of 13, doctors refer to the condition as childhood-onset schizophrenia or COS. The long-term outlook for this rare condition is generally more severe than the outlook for adult schizophrenia. In its initial stages, COS also produces signs that look quite different than the signs of schizophrenia commonly found in older people. Things doctors look for include:
- Delays in the development of age-appropriate language skills
- Delays in the normal transition from crawling to walking
- Unusual crawling behaviors
Doctors also look for unusual body movements, such as arm-flapping or body-rocking, similar to those sometimes seen in adults.
Over time, a child with COS may develop hallucinations, delusional thinking and other more widely recognized schizophrenia symptoms. However, doctors frequently have a hard time identifying the condition in its early stages. This is true, in part, because early symptoms frequently take vague forms that elude easy detection. In addition, when obvious symptoms do arise, they often resemble other conditions that can lead to delayed childhood development. Some studies indicate that doctors only correctly identify about 55% of all COS cases with typical outpatient screenings. In addition, it turns out that many children initially diagnosed with childhood-onset schizophrenia actually have some other mental health problem.
Treatment in Children
Medication may not play as big a role in the treatment of COS as it typically does in the treatment of schizophrenia in older people. That’s because most of the antipsychotics prescribed for teens and adults don’t have FDA approval for use in people under the age of 13. When children do receive medication, doctors work hard to identify the minimum effective dose and avoid any side effects or complications. Forms of psychotherapy used to treat the condition may include both family therapy and individualized therapy. Life-skills training may focus on academics, socialization or a combination of both of these areas. Periodic hospitalization may be necessary if your young child experiences severe psychotic episodes.
National Institute of Mental Health: Schizophrenia https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
Mayo Clinic: Childhood Schizophrenia
Current Psychiatry Reports: Childhood-Onset Schizophrenia – The Challenge of Diagnosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289250/