Schizophrenia in Children (A complete Guide)

In this guide, we will discuss what Schizophrenia in children means, symptoms and treatment options. 

Schizophrenia in children: what is it?

Schizophrenia in children (childhood schizophrenia) is considered an uncommon but severe mental disorder in which children interpret their reality in an abnormal way. According to the Mayo Clinic, “It may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs your child’s ability to function.”

According to the Mayo Clinic, schizophrenia during childhood is uncommon but it is considered a severe mental disorder where a child interprets reality in an abnormal way. Since it is a chronic condition, it requires lifelong treatment where early identification is key to reduce the impact of schizophrenia and improve the child’s long-term outcome.

This disease involves a series of problems related to thinking, behaving, and emotions. It is a disabling condition that may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior.

Additionally, the main difference between schizophrenia in children and adult schizophrenia is the time of presentation. Having a major impact early in life, on the child’s normal development and behavior, but manifesting with the same severity and symptomatology. 

Rochelle Caplan, MD, professor of Child Psychiatry at the UCLA Semel Institute, is an expert in schizophrenia in children and she says:

“In most cases, schizophrenia has its onset primarily in adolescence and in young adulthood, but childhood schizophrenia does occur but it is much more infrequent than the delay onset schizophrenia. In most cases, the onset is quite gradual and a child might become more isolated, might appear to be having difficulties with attention because they are actually paying attention to internal stimuli such as the hallucinations or to their delusional thoughts…”

Additionally, she mentions that the child might appear very anxious because it is considered a scary experience when experiencing hallucinations because the content might be perceived as threatening (e.g. Someone is going to kill them or trying to) or they can have an accusatory nature (e.g. You are a terrible child). 

Children understand at the onset of the disease that seeing or hearing things is very unusual, but if you are a parent you may only notice how they have become very irritable and angry, probably having a decline in school due to their difficulty concentrating. If you notice any sudden and abrupt changes in your child’s behavior it is important to take him/her to see a professional for a complete assessment.

Symptoms

Schizophrenia is now presented as a spectrum, so it involved a range of problems and symptoms may vary from one person to the other. However, they usually involve as discussed previously, delusions, hallucinations or disorganized speech impacting the child’s overall ability to function.

It has been suggested that the presentation of the symptoms for schizophrenia usually starts in the mid to late 20s and the manifestation of the symptoms in children tend to be uncommon, however, schizophrenia in children tends to occur before age 18 and even earlier in life (extremely rare) before age 13. 

Additionally, the symptoms can range in severity and type over time, including periods of remission and periods where symptoms get worse.

In contrast, childhood schizophrenia can be difficult to recognize earlier in life making it challenging for mental health professionals to diagnose. 

Early signs and symptoms

According to the Mayo Clinic and WebMD, some of the early signs and symptoms are:

• Delays in language acquisition
• Unusual or late crawling
• Late walking
• Other abnormal motor behaviors such as rocking or arm flapping
• A limp or slumped posture
• Floppy arms or legs
• Being inactive or listless for long periods

These signs and symptoms are also common to other neurodevelopmental disorders such as autism, so it is necessary to have a mental health professional rule out all the other conditions. Additionally, paranoid symptoms may falsely be diagnosed 

Additionally, symptoms may occur suddenly or may happen over time, where your child may start talking about strange ideas or fears, act clingy or withdraw from family and other people.

The mhanational.org also identifies early warning signs such as feeling like their brain is not working, feeling like their mind/eyes are playing tricks on them, seeing and/or hearing things that are not there, vivid and bizarre thoughts and ideas, increased sensitivity to light, sounds, smells or touch, severe problems in making and keeping friends, among others.  

Symptoms in children

According to WebMD, some of the symptoms that may manifest in children may include:

• Inability to differentiate between reality and dreams, stories, TV shows, etc.
• Intense fear about someone or something wanting to hurt them.
• Feeling, hearing or seeing things that are not there (hallucinations).
• Appears as extremely anxious or afraid.
• The inability for emotional expression when speaking.
• Confused behavior, agitation and periods of sitting and staring.
• Acting as a much younger child.

Schizophrenia in Teenagers

Symptoms manifested by teenagers with schizophrenia are similar to the ones manifested by adults, but it may be more difficult to recognize and diagnose. This may be due to the fact that some of the symptoms manifested may resemble the typical behaviors during teen years, such as (Mayo Clinic):

• Withdrawal from friends and family
• A drop in performance at school
• Trouble sleeping
• Irritability or depressed mood
• Lack of motivation
• Strange behavior
• Substance use

When compared to symptoms manifested in adults, teenagers may be:

• Less likely to have delusions
• More likely to have visual hallucinations

Signs and Symptoms during child development

During the normal development of children with schizophrenia and while they age, more of the typical symptoms manifested in adults tend to manifest. Symptoms may include:

• Hallucinations: the most common hallucinations are visual and auditory, however, for someone with schizophrenia.
• Delusions: These are false beliefs when contrasted to reality, involving being harmed or harassed, being famous or having exceptional abilities, or believing that a major catastrophe is about to take place. 
• Disorganized thinking: evident through disorganized speech, where effective communication is impaired and the answers to questions may be completely unrelated or partially related. In some cases, speech may include meaningless words or words only the child is able to interpret. 
• Negative symptoms: reduced or lack of the ability to function properly in normal daily life activities or tasks. Some examples are neglecting personal hygiene or blunt affect, apathy, anhedonia or loss of interest in activities that were enjoyable, poverty of speech and thought or body language won’t match facial expressions. 
• Extremely disorganized or abnormal motor behavior: this may manifest in several ways, from irritability and agitation to childlike silliness. This type of behavior is not goal-oriented which makes hard to complete tasks. Some behaviors manifest in the inability or resistance to follow instructions, bizarre posture, lack of response or excessive movement.  

When these symptoms lessen in severity because of treatment, but are not fully treated, one is said to have Residual Schizophrenia.

Causes of schizophrenia in children

Researchers and experts on the subject cant pinpoint the exact causes of schizophrenia and why it gets to develop earlier in life. However, they have suggested genetics may have an active role where more than one family member has developed the condition and if there is one of the parents or both with schizophrenia, the risk of having a child with schizophrenia increases. 

How does Schizophrenia gets diagnosed?

A mental health professional such as a pediatric psychiatrist, is qualified to diagnose schizophrenia in children, however, since the symptoms tend to overlap with other conditions, the diagnosis can become very challenging. 

There is no specific test to diagnose schizophrenia, however, mental health professionals may use blood tests, physical exams, mental health tests, brain scans, and other exams to diagnose a child with schizophrenia. 

Treatment

Since schizophrenia is a long-life condition and if your child has been diagnosed with this mental illness,  it is very likely that he/she may need treatment throughout their lives. The treatment or ways to manage this condition is very similar to the treatment provided to adults. This includes:

• Antipsychotic medications also called neuroleptics. They are used to manage symptoms such as delusions and hallucinations. However, it is important to ask your doctor to be aware of the side effects of these types of medication. 
• Psychotherapy. A mental health professional may help your child manage the symptoms. Additionally, you may consider family therapy and support groups to understand how to manage the condition and daily life activities. 
• Life skills training. This type of training may help your child to cope at school, teaching social skills and how to do daily tasks. 

If your child’s symptoms are severe or it is going through a crisis, a stay in the hospital is recommended to get the symptoms treated in a controlled environment. 

Why is this blog about schizophrenia in children important?

Schizophrenia in children is considered rare but it can be very disabling and have a severe presentation of symptoms. It is important to raise awareness about this condition and the importance of diagnosing and having an early treatment of the symptoms.

As a parent, you may not notice anything unusual at first but if there are sudden changes in their behavior and one or more areas (e.g. School or relationship with others) are being affected by it, it is important to take them to a professional for a complete assessment to rule out any organic conditions or other mental illness. 

Please feel free to comment in the comments section below!

Frequently Asked Questions (FAQs) about schizophrenia in children

Recommended books

• Daylight: A True Story of Childhood Schizophrenia
• Is That My Child?: A Parents Guide to Dyspraxia, Dyslexia, ADD, ADHD, OCD and Tourette’s Syndrome of Childhood
• Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness
• Time to Heal: Corrective Socialization: A Treatment Approach to Childhood Schizophrenia
• Communication Therapy in Childhood Schizophrenia: An Auditory Monitoring Approach

References 

Mayo Clinic

Mhanational.org

WebMD: Childhood Schizophrenia 

PsyCom

Childmind.org

Medical News Today