Childhood schizophrenia is a rare form of schizophrenia, a mental health illness.
Apart from the age of onset, childhood schizophrenia is similar to adult schizophrenia. However, the symptoms can affect children and adults differently. In the long term, the symptoms may be more severe in people who develop them early.
In this article, we focus on how schizophrenia affects children.
In the past, some autistic children may have incorrectly received a diagnosis of schizophrenia. Distinguishing schizophrenia from autism and other conditions remains a challenge.
Schizophrenia is rare among children, and some of the symptoms and risk factors may overlap with those of autism. In addition, some family and genetic studies have identified similarities between autism and childhood schizophrenia.
As a result, in some rare cases, it can take time to obtain a correct diagnosis of schizophrenia in children. Doctors are likely to be able to diagnose autism much more quickly.
The symptoms of schizophrenia in children are similar to those in adults, but they can have different implications.
The symptoms include:
- auditory hallucinations, in which the child hears voices
- developmental delays
- language difficulties
- difficulty coping with school work and social relationships
- trouble expressing or recognizing emotions, known as “flat affect”
Flat affect may be noticeable during social interactions, emotional films, and cartoons. It can also affect the ability to identify another person’s emotions by looking at their face.
In more than half of the children who go on to develop childhood schizophrenia, unusual features are present from the early months of life.
The American Academy of Child & Adolescent Psychiatry (AACAP) note that changes may slowly occur over time. Children who previously made friends easily or did well at school may start to find these things challenging.
The AACAP add that parents and caregivers may notice that their child:
- has unusual behavior or speech
- has unusual or bizarre thoughts and ideas
- confuses television and dreams with reality
- seems confused in their thinking
- experiences severe mood changes
- shows changes in their personality
- believes that someone is after them or talking about them (paranoia)
- appears anxious and fearful
- has difficulty relating to peers and maintaining friendships
- becomes withdrawn and increasingly isolated
- neglects their personal grooming
The child may not always be aware that their experiences are different than those of other people.
Research suggests that schizophrenia symptoms may be more severe in children than in adults.
In the video below, Prof. Rochelle Caplan, an expert on childhood schizophrenia, talks about how the symptoms appear and the effect that they can have. The Child Mind Institute, a nonprofit organization, produced the video.
Prof. Caplan describes how symptoms appear gradually in most cases. She explains how the experience can be “very scary” for the child at first. To parents or caregivers, this may present similarly to anxiety.
The child may feel afraid, for example, because the hallucinations or delusions can feel threatening.
The child might also have trouble paying attention, and they may become irritable or have difficulty sleeping. Prof. Caplan notes that some of these changes can resemble rebellious behavior.
Understanding what the child is experiencing can help parents and caregivers react in a constructive way that can help the child.
According to the authors of one case study, early onset schizophrenia is when a child aged 13–18 years experiences symptoms of schizophrenia.
Very early onset schizophrenia is when symptoms appear before the age of 13 years.
The researchers describe a child who experienced unusual perceptions from the age of 3 months.
There are no separate criteria to distinguish between childhood and adult schizophrenia.
It can be challenging for doctors to diagnose early onset schizophrenia.
One reason for this difficulty is that the condition is rare. In addition, other conditions may result in similar behaviors and symptoms.
- bipolar disorder
- personality disorders
- post-traumatic stress disorder
- some types of obsessive-compulsive disorder
Autistic children may have characteristics that resemble those of schizophrenia, such as:
- social withdrawal
- unusual communication styles
- avoiding eye contact
As with adult schizophrenia, there is no single diagnostic test for the disorder in children, and diagnosis relies on the elimination of other conditions and disorders that could explain the symptoms.
Doctors will use the same criteria for childhood schizophrenia as for adult schizophrenia.
Treatment is available for children with schizophrenia.
Drugs called antipsychotics help manage hallucinations, delusions, and disorganized thinking. One example is clozapine (Clozaril), but a healthcare professional may be able to recommend other options.
Depending on the drug, adverse effects can include:
- rapid heartbeat
- a low white blood cell count
- movement side effects
- weight gain
- high fat levels in the blood and other metabolic symptoms
However, it is important to continue taking the drugs unless a doctor changes the prescription. If a person stops taking them, the symptoms will return.
Antipsychotic treatments do not cure schizophrenia. The person will need to take medication throughout their life to manage the symptoms and prevent psychosis.
Experts encourage families to take an active role in caring for a loved one with schizophrenia and helping them face the ongoing challenges.
Schizophrenia is a lifelong condition. It is not possible to cure or prevent it, but treatment can help manage it.
If a child has a diagnosis of schizophrenia, their family and caregivers can help by learning as much as they can about the condition, trying to understand how the child feels, and ensuring that they receive ongoing treatment.
Depending on the type and severity of symptoms, treatment can help many people with the condition go on to work and enjoy fulfilling relationships.