What is Schizophrenia?
Schizophrenia is a medical illness that causes strange thinking,
abnormal feelings, and unusual behavior. It is an uncommon psychiatric
illness in children and is hard to recognize in its early phases. The
behavior of children and teens with schizophrenia may differ from that
of adults with this illness.
Mounting evidence indicates that
schizophrenia has neurodevelopmental roots. The appearance of
schizophrenic symptoms before age 12 is rare (less than one-sixtieth
as common as the adult-onset type), but studying these cases is
important for an understanding of this disorder.
Neurodevelopmental damage seems to be
greater in childhood schizophrenia than in the adult-onset type. Most
schizophrenic children show delays in language and other functions
long before their psychotic symptoms (hallucinations, delusions, and
disordered thinking) appear, usually at age seven or later. In the
first years of life, about 30% of these children have transient
symptoms of pervasive developmental disorder, such as rocking,
posturing, and arm flapping. Childhood home movies indicate uneven
motor development, such as unusual crawling, in adult-onset
schizophrenic patients. Children with schizophrenia may be even more
seriously impaired in this respect; they are also more anxious and
disruptive than adult-onset schizophrenic patients were as children.
Early Warning Signs:
- trouble discerning dreams from
reality
- seeing things and hearing voices
that are not real
- confused thinking
- vivid and bizarre thoughts and ideas
- extreme moodiness
- peculiar behavior
- concept that people are "out to get
them"
- behaving younger than chronological
age
- severe anxiety and fearfulness
- confusing television or movies with
reality
- severe problems in making and
keeping friends
The behavior of children with this
illness may change over time. The schizophrenic psychosis develops
gradually in children, without the sudden psychotic break that
sometimes occurs in adolescents and adults. Children may begin talking
about strange fears and ideas. They may start to cling to parents or
say things that do not make sense. Children who used to enjoy
relationships with others may become more shy or withdrawn and seem to
be in their own world.
Treatment
Early diagnosis and medical treatment are important. Children with
the problems and symptoms listed above must have a complete
evaluation. These children may need individual treatment plans
involving other professionals. A combination of medication and
individual therapy, family therapy, and specialized programs (school,
activities, etc.) is often necessary. Psychiatric medication can be
helpful for many of the symptoms and problems identified.
Standard antipsychotic drugs appear to
be effective for schizophrenic children and adolescents, and the
atypical drug clozapine is helpful for at least half of those who do
not respond to typical drugs. In a few cases their psychotic symptoms
seem to disappear entirely. Unfortunately, children may be more
susceptible than adults to the toxic effects of clozapine; about one
third of them have to stop taking it because of the side effects.
Newer antipsychotic drugs that may be safer and just as effective are
now being tested.
Parents need to ask their family
physician or pediatrician to refer them to a child and adolescent
psychiatrist who is specifically trained and skilled at evaluating,
diagnosing, and treating children with schizophrenia.
Source: National Mental Health
Association
