Identifying Schizophrenia in Children

Identifying Schizophrenia in Children Schizophrenia Print Identifying Schizophrenia in Children Childhood-Onset Schizophrenia Is Rare But Serious By Amy Morin, LCSW facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our editorial policy Amy Morin, LCSW Medically reviewed by Medically reviewed by Steven Gans, MD on January 05, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 03, 2019 Schizophrenia Overview Symptoms & Diagnosis Causes & Risk Factors Treatment Living With In Children In This Article Table of Contents Expand Prevalence Causes Symptoms Course When to See a Doctor Diagnosis Treatments Prognosis Coping and Support View All Learning your child has schizophreniaâ€"or suspecting your child may have itâ€"can feel  overwhelming and scary. But early identification and treatment are important in managing the symptoms and improving your child’s long-term prognosis. Schizophrenia is a mental illness that causes people to interpret reality abnormally. It involves a range of cognitive, emotional, and behavioral problems that impair a child’s ability to function. Verywell / Cindy Chung Prevalence Onset usually occurs between the  late teens and the mid-thirties. The peak age of onset for males is the early twenties and for females the late twenties, but it may occur at any age. According to the Institute of Mental Health, about .25 to .64% of Americans have schizophrenia.?? Childhood schizophrenia, characterized by onset before age 13, is only found in 1 in 40,000 children. Childhood schizophrenia presents special challenges in terms of diagnosis and treatment.?? Causes Scientists haven’t found a single set of causes for schizophrenia. It’s suspected that there are multiple genetic and environmental factors that play a role:?? Genetic Factors -  Family, twin, and adoption studies support a strong genetic component in schizophrenia. Parents of children with schizophrenia are ten times as likely to also develop schizophrenia.?? If an identical twin has the illness, the likelihood that the other twin will develop schizophrenia is over 40 percent.??Environmental Factors -  There may be some environmental factors that contribute to schizophrenia in children, especially if there are already genetic components at play. Prenatal infections, obstetric complications, and maternal famine may play a role.?? Symptoms Hallucinations, thought disorder, and flattened affect have been consistently found in children with schizophrenia. Delusions and catatonic symptoms occur less frequently.?? Childhood schizophrenia is often associated with cognitive delays. Cognitive decline typically occurs at the time of onset of schizophrenia. Intellectual deficits appear to be stable over time without continued deterioration.?? Here are the symptoms of schizophrenia:?? Hallucinations â€" Seeing or hearing things that aren’t actually thereDelusions â€" False ideas that are believed by the individual but not by othersDisorganized thinking - Evidenced by derailed or incoherent speechFlat affect â€" Monotone, diminished facial expressions, and appear apatheticPaucity of speech or thought â€" Only speaking when prompted and replying with short answersBizarre behavior â€" Inappropriate, disorganized, or odd behavior inappropriate for a child’s age Course The course of schizophrenia varies from person to person. But, there are hallmark phases that individuals tend to experience. Prodrome phase  â€" Most individuals with schizophrenia experience some functional deterioration before the onset of psychotic symptoms.?? Social withdrawal, bizarre preoccupations, unusual behavior, academic failure, or a decline in hygiene and self-care may begin before any signs of psychosis.Acute phase â€" This phase is marked by prominent symptoms, such as hallucinations, delusions, disorganized speech and behavior, and a serious deterioration in functioning. This phase may last several months depending on the response to treatment.??Recuperative/Recovery phase â€" After the acute psychosis subsides, there is generally a several-month period when the individual continues to experience a significant impairment. Flat affect and social withdrawal are often present.??Residual phase â€" Children with schizophrenia may have several months or more between acute phases. However, most individuals will continue to be at least somewhat impaired. Some individuals never progress to residual symptoms and continue to have symptoms despite treatment.?? When to See a Doctor It’s hard to identify schizophrenia in children. Young children have excellent imaginations so it’s common for them to have imaginary friends with whom they carry on conversations. That type of pretend play doesn’t mean your child is having hallucinations. Kids also aren’t good at telling adults about their symptoms. When young children are asked questions about hallucinations or delusions, many of them say yes. But, that doesn’t mean they have psychosis. Instead, in a paper published in 2013, researchers believe kids may report having those symptoms because they have overactive imaginations, cognitive limitations, or they simply misunderstand the question. So asking your child questions like, “Do you ever see things that no one else sees?” isn’t likely to give you much insight into whether your child should see a doctor.?? Symptoms also tend to begin gradually. Over time, however, a child may develop psychosis and the symptoms become much more obvious. If you notice developmental delays, strange eating rituals, bizarre behavior or ideas, change in academic performance, or social isolation, consult your childs doctor. Since schizophrenia in children is rare, there’s a good chance the symptoms may stem from something else. But it’s important to find out the reasons for the changes that you’re seeing. Diagnosis There isn’t a lab test that identifies schizophrenia. Mental health professionals make the diagnosis based on several factors, after gathering a full history, observing the child, and interviews with the parent and child. Other conditions must also be ruled out. Schizophrenia Discussion Guide Get our printable guide to help you ask the right questions at your next doctors appointment. Download PDF Many of the symptoms of schizophrenia in children are also found in other disorders, such as autism spectrum disorders, mood disorders with psychotic features, or obsessive compulsive disorder.?? Medical conditions may also result in psychosis. Central nervous system infections, endocrine disorders, genetic syndromes, autoimmune disorders, and toxic exposures may cause children to exhibit symptoms similar to those found in schizophrenia.?? Drug use may also cause psychosis. Hallucinogenic mushrooms, stimulants, inhalants, and cannabis are just a few of the drugs that may lead to psychotic symptoms. Prescription drug misuse may also lead to acute psychosis. Symptoms resolve within a few days to weeks after the drug is discontinued.?? All of those other conditions must be ruled out before a diagnosis of schizophrenia can be made. How Mental Health Professionals Use the DSM Today Treatments Antipsychotic medication is the primary treatment for schizophrenia in children as well as adults. Individuals with schizophrenia are at significant risk of relapse if antipsychotic medication is discontinued. It’s essential for parents to maintain contact with physicians to monitor symptoms, side effects, and adherence.?? Talk therapy may also be helpful to children with schizophrenia. Children and their parents may benefit from psychoeducation and problem-solving sessions. It may be important for siblings to get involved in therapy so they can understand their brother or sister’s behavior.?? Social skills training, relapse prevention, and basic life skills training may be helpful. Some children with schizophrenia may need specialized education programs or vocational training programs. If a child becomes a danger to herself or others, a psychiatric hospitalization may be necessary. Inpatient treatment can be helpful in getting symptoms under control. The 9 Best Online Therapy Programs Prognosis Childhood-onset schizophrenia is associated with low intellectual functioning and higher rates of negative symptoms across the lifespan. According to a 2011 study published in Pediatric Clinics of North America, childhood-onset schizophrenia is associated with greater social deficits in adulthood compared to those with other mental illnesses.?? It’s also been linked to lower level of employment and a lesser likelihood of living independently, compared to other psychiatric disorders.?? Adolescents are at a higher risk of suicidal behavior during their first episode of psychosis. At least 5 percent of people who exhibited symptoms of schizophrenia before age 18 die by suicide or accidental death directly related to behaviors caused by their psychotic thinking.?? Individuals with schizophrenia are at a higher risk of physical health conditions such as heart disease, obesity, hepatitis, diabetes, and HIV. There isn’t a cure for schizophrenia, but symptoms can be managed with treatment. Early intervention is key to improving the outcome for children with schizophrenia.?? Coping and Support Learning your child has schizophreniaâ€"or suspecting that he or she may have itâ€"can feel scary and overwhelming. It’s important to learn as much as you can about schizophrenia in children, however, so you can best support and advocate for your child. Ask your child’s doctor for resources on schizophrenia. Attending support groups for people who have a family member diagnosed with schizophrenia could serve as a wealth of information. The National Alliance on Mental Illness, NAMI, may also be a valuable resource. NAMI is a mental health organization who has local affiliates who provide support, education, and services in communities throughout the United States. NAMI may be able to help you locate the resources, tools, and information you need to help your child. It’s important to take care of yourself as well. Attend a support group or seek therapy for yourself. Managing your stress level will be key to helping you be best equipped to support your child. 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