Childhood Schizophrenia
Childhood schizophrenia is a chronic disorder involving abnormal thought and social behavior.
Schizophrenia is quite rare in childhood; it typically develops in late adolescence and early adulthood (see Section 7, Chapter 107). When schizophrenia does develop in childhood, it usually begins between the age of 7 and the start of adolescence.
Schizophrenia probably occurs because of chemical abnormalities in the brain. Doctors do not know what causes these abnormalities, although it is clear that there is an inherited vulnerability and that it is not caused by poor parenting or adverse childhood conditions.
Symptoms and Diagnosis
A child with schizophrenia typically becomes withdrawn, loses interest in activities, and develops distorted thinking and perception. These symptoms may continue for some time before progressing. As with adults, children with schizophrenia are likely to develop hallucinations, delusions, and paranoia, often fearing that others are planning to harm them or are controlling their thoughts. Children with schizophrenia typically have blunted emotions--neither their voice nor facial expressions change in response to emotional situations. Events that would normally make people laugh or cry may produce no response. In adolescents, use of illicit drugs may mimic symptoms of schizophrenia.
There is no specific diagnostic test for schizophrenia. A doctor bases the diagnosis on a thorough assessment of the symptoms over time, psychologic tests, and lack of evidence of an underlying medical condition, such as drug abuse, a brain tumor, and other disorders.
Treatment
Childhood schizophrenia cannot be cured, although hallucinations and delusions may be controlled with antipsychotic drugs, such as haloperidol, olanzapine, quetiapine, and risperidone (see Section 7, Chapter 107). Children are particularly susceptible to the side effects of antipsychotic drugs, such as tremors, slowed movements, and movement disorders. Psychologic and educational support for the child and counseling for family members are essential to help everyone cope with the illness and its consequences.
Children with schizophrenia may need to be hospitalized at times when the symptoms worsen, so that drug doses can be adjusted and their safety can be assured.
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