Childhood Schizophrenia

Overview

What is childhood schizophrenia?

Childhood schizophrenia is a mental illness that affects children under the age of 13. It is also known as early-onset schizophrenia. Childhood schizophrenia is rare, and affects an estimated 0.4 percent of children.

Childhood schizophrenia may be hard to diagnose, especially in young children, because the symptoms are similar to those of other mental health conditions. These children may have other behavioral problems and difficulties with daily living.

Who is likely to have childhood schizophrenia?

Any child can develop early schizophrenia. Some risk factors increase a child’s likelihood of developing this condition. These risks include:

  • Brain structure. Some people develop too few or too many connections between neurons (brain cells).
  • Family history of schizophrenia or other personality disorders
  • Father older than 30 years old at the time of conception
  • Genetic risk factors. Some people have changes to their genes. These changes can be inherited (passed down through families) or happen on their own.
  • Neurotransmitters that do not function correctly or do not function at all. Neurotransmitters are chemicals released by neurons that help control body systems and processes. With schizophrenia, the neurotransmitters dopamine or serotonin may not work as usual.

Symptoms and Causes

What causes childhood schizophrenia?

The exact causes of childhood schizophrenia are unknown. Schizophrenia tends to be hereditary (runs in families). Researchers have also found some other factors that may play a role in developing schizophrenia, including:

  • Complications during birth
  • Maternal malnutrition (the mother doesn’t get the proper nutrition during pregnancy)
  • Mother is exposed to certain viruses while pregnant

What are the symptoms of childhood schizophrenia?

Childhood schizophrenia causes symptoms similar to schizophrenia in adults. In many cases, children who have schizophrenia first show social and developmental delays that occur with other conditions, including:

  • Disorganized behaviors, including inappropriate outbursts
  • Motor skill delays, including a delay in learning to walk
  • Poor attention span
  • Poor eye contact
  • Poor performance in school
  • Speech delays or other problems, such as echolalia (repeating noises or words spoken by other people)

What are positive, negative and cognitive symptoms of schizophrenia?

During the acute (active) phase of schizophrenia, children may show symptoms called positive, negative, and cognitive (thinking) symptoms.

Positive symptoms are psychotic behaviors. During psychosis, a person is not connected with reality. Positive symptoms may include:

  • Delusions (false or erroneous beliefs; for instance, that people are plotting against the person)
  • Hallucinations
  • Movement disorders (unusual movements or behaviors)
  • Thought disorders (unable to organize and control thinking)

Negative symptoms of childhood schizophrenia disrupt normal behaviors or emotions. Negative symptoms may include:

  • Speaking infrequently or not at all
  • Limited or no display of emotions
  • Feeling no pleasure in everyday life
  • Problems with starting or finishing activities
  • Isolation (avoiding friends and relatives)

Cognitive symptoms of childhood schizophrenia reflect changes in thinking or memory. These symptoms may include:

  • Being unable to understand information and make decisions
  • Poor attention span
  • Trouble focusing on a task

Diagnosis and Tests

How is childhood schizophrenia diagnosed?

Schizophrenia in children is difficult to diagnose. Many healthy, nonpsychotic children have hallucinations or delusions. For example, a young child may talk to an imaginary friend.

Also, other psychiatric illnesses can cause symptoms that may be mistaken for schizophrenia. These conditions include attention deficit hyperactivity disorder (ADHD), major depressive disorder, bipolar disorder and schizoaffective disorder.

No one test can tell whether a child has schizophrenia. To make a diagnosis, a doctor must rule out other diseases or conditions, and consider other psychiatric illnesses, developmental disorders or drug toxicity.

Doctors diagnose childhood schizophrenia with a combination of mental and physical tests. To check for physical causes, your doctor may use:

  • Magnetic resonance imaging (MRI): This test uses radio waves and strong magnetic fields to help doctors see whether there are any abnormalities in the brain.
  • Positron emission tomography (PET) and single photon emission computed tomography (SPECT): A radioactive chemical called a tracer is injected into the bloodstream to allow the doctor to see blood flow in the brain.

Management and Treatment

How is childhood schizophrenia treated?

Treatment for early schizophrenia depends on the child and the type and severity of symptoms. Treatment usually includes therapy and education for both patient and family. Depending on the child’s age, the doctor may prescribe antipsychotic medications to help control symptoms.

In addition to medications, doctors often recommend social skills training and counseling for the child and family. Ongoing individual therapy helps children with schizophrenia learn coping skills. This support can help them maintain relationships and do well in school.

What complications are associated with childhood schizophrenia?

Childhood schizophrenia may cause difficulties throughout a child’s life, and can affect learning, memory, relationships and productivity.

There is no cure for schizophrenia. Even when they are adults, these children will have various symptoms of the condition. They need continuous treatment to help them live a safe, productive life.

Prevention

Can childhood schizophrenia be prevented?

There is no way to prevent schizophrenia in children. You can lower your child’s risk by avoiding known risk factors during pregnancy, such as malnutrition.

Outlook / Prognosis

What is the prognosis (outlook) for people who have childhood schizophrenia?

The outlook for children with schizophrenia depends on the severity of their symptoms. Many children affected by early schizophrenia have a poor prognosis. Early, ongoing treatment offers the best hope.

Living With

When should I call my doctor about schizophrenia in my child?

Speak with your doctor if your child begins to show any signs of social or developmental delays. In many cases, these signs are the first indications of early schizophrenia.

Last reviewed by a Cleveland Clinic medical professional on 04/09/2019.

References

  • National Alliance on Mental Illness. Early-Onset Schizophrenia. (https://namicobb.org/early-onset-schizophrenia/) Accessed 4/11/2019.
  • American Academy of Child & Adolescent Psychiatry. Schizophrenia In Children. (https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-guide/Schizophrenia-In-Children-049.aspx) Accessed 4/11/2019.
  • American Academy of Pediatrics. Schizophrenia. (https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Schizophrenia.aspx) Accessed 4/11/2019.
  • National Institute of Mental Health. Schizophrenia. (https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml) Accessed 4/11/2019.

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