Schizophrenia In Children - What You Must Know

Schizophrenia In Children

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Those of you who have seen Russell Crowe’s beautiful and poignant portrayal of Dr. John Nash in ‘A Beautiful Mind,’ may know a little bit about schizophrenia. You may have shed a few tears during the movie and sympathized with the main protagonist. Some may have even considered themselves lucky that they don’t have a family member with schizophrenia. So, imagine the plight of a mom when a specialist tells her that her kid has schizophrenia. Devastating isn’t it?

Here, we talk about schizophrenia in children and how it can affect their life.

Child Schizophrenia:

Before we discuss child schizophrenia, it is important you understand what schizophrenia is. Forget about Norman Bates and the Bates Motel. Just because your little one has schizophrenia, it doesn’t mean he will turn into the Psycho Norman Bates and kill people while dressing up like a woman!

Yes, Schizophrenia is a chronic psychiatric illness. It will distort your child’s thinking and lead to many delusions and hallucinations. These are the positive symptoms. Unfortunately, where there is positive, you will have to find a negative too. The negative symptoms include no emotions, social isolation, and aggression.

Schizophrenia in children is rare, and because kids are still growing and developing mentally and physically, it is tough to recognize the symptoms in the early stages of the illness [1]. Your little one will perceive hostile intent that is not there, and a teacher may attribute this to a behavioral problem. Your kiddo may believe that someone is controlling his thoughts or reading his mind. He may even tell you that he is getting a special message from TV shows. These are part of the paranoid delusions that schizophrenia causes.

[ Read: Behavioral Problems In Children ]

What Causes Schizophrenia In Children?

Researchers still don’t know what causes schizophrenia in children. They believe that it develops the same way as schizophrenia in adults. In fact, researchers are still grappling why psychosis (another name for schizophrenia) develops in some people early and not so in others. It is not a single cause that leads to schizophrenia. Rather, it is a complex interaction between your kid’s genetics and the environment.

1. Genetics:

There appears to be a genetic factor associated with schizophrenia. So hereditary plays a role. A person has about 10 percent chances of getting schizophrenia if he has a schizophrenic parent or sibling [2]. On the other hand, someone with no first-degree relative with schizophrenia has a one percent chance of developing the condition.

Don’t blame yourself if your little angel has schizophrenia. Yes, the illness is influenced by genetics, but at the same time, genetics do not determine it. It can run in your family, but it isn’t necessary for your offspring to have it. In fact, even if your child has the predisposition to schizophrenia, it isn’t necessary that he will develop it. So, you can safely say it is not your little one’s destiny to have the illness.

2. Environment:

While your kid may have the genes that predispose him to schizophrenia, ultimately, environmental factors will be responsible for triggering this psychiatric illness. Based on the research results, scientists believe stress during pregnancy or at a later developmental stage cause the stress hormone, cortisol, levels to spike in the body. This increased level is said to be the trigger to schizophrenia.

Some stressful situations that can trigger this illness include:

  • Physical abuse during childhood
  • Childhood sexual abuse
  • Being exposed to a viral infection in the womb
  • Low levels of oxygen during birth which can happen during prolonged labor and premature birth
  • Early parental loss through death or separation
  • Being exposed to a virus as an infant

3. Abnormal Structure Of The Brain:

Abnormal brain structure can also have a role to play in causing psychosis in children. Researchers have found that schizophrenics have enlarged brain ventricles. This means there is a reduction in the volume of tissue of the brain. Also, there appears to be little activity in the frontal lobe of the brain. This area of the brain is responsible for decision making, planning, and reasoning.

In some studies, researchers have found abnormalities in the hippocampus, temporal lobes, and amygdala, and are linked to the positive symptoms that schizophrenics experience.

While there is research to suggest that brain structure plays a role in schizophrenia, you cannot assume that it is just one problem in your kiddo’s brain that causes the disease. As we mention earlier, there are complex and intricate interactions that lead to schizophrenia.

Signs Of Schizophrenia In Children:

In the case of children, symptoms of schizophrenia appear gradually. The early signs of the disease may be so vague that you may not think there is anything wrong with your little angel. Or, you may just think it is a normal part of your child’s development.

However, the symptoms of schizophrenia worsen with time, and this is when you will begin noticing them. And, ultimately, your child will face delusions, hallucinations, and problem organizing his thoughts. When his thoughts become more disorganized, he will lose touch with reality, and this will result in hospitalization or medication.

a. Early Signs Of Schizophrenia:

Usually, the initial signs of schizophrenia in kids include developmental problems. These problems may include the following:

  • Late walking
  • Language delay
  • Late crawling
  • Rocking
  • Flapping of the arms

It is important to realize that some of the developmental issues are similar to other developmental conditions, such as autism. Hence, it is important the specialist first rules out these developmental disorders before diagnosing schizophrenia.

[ Read: Developmental Disorders In Children ]

b. Teenage Signs Of Schizophrenia:

As your little one turns into a teenager, he will have symptoms that are similar to those experienced by adults. However, even then it can be tough to recognize the disorder. This is primarily because some of the symptoms of schizophrenia are very similar to the typical behavioral patterns teenagers display during their adolescence.

Symptoms of schizophrenia that are present during teen years include:

  • Withdrawing from family and friends
  • A change in school performance for the worse
  • Having troubles sleeping
  • Irritability
  • Depressed mood
  • Strange behavior
  • No motivation

When you take adolescents, they are less likely to suffer from delusions but are more likely to experience visual hallucinations.

c. Later Signs Of Schizophrenia:

As your kiddo grows up, he will start manifesting the typical symptoms of schizophrenia, which may include:

i. Hallucinations:

Any of your kiddo’s sense could involve hallucinations. Invariably, your child may see or hear things that don’t really exist. However, for your little one, these hallucinations are real, and he will believe that they actually exist.

ii. Delusions:

As painful as it may sound, but the fact remains your child will have delusions. These false beliefs may lead him to believe that he is being harassed or harmed. He may also believe that certain comments are directed at him. Or, he may tell you that his body is not functioning as it should, and there is something the matter with it.

iii. Disorganized Thought Process:

Your child will have a disorganized thought process, which, in turn, will lead to disorganized speech. Communication will be impaired, and your child may not answer questions. Either he will give partial answers or may offer an answer that is not related to the what you ask. On rare occasions, children may club meaningless words together to form sentences. This is known as word salad.

iv. Abnormal Or Disorganized Motor Behavior:

You may notice that the behavior is not goal-oriented. As a result, your child will find it difficult to perform and complete tasks. He may adopt a bizarre or inappropriate posture, not respond to you or anyone else, display excessive movements, be catatonic (lack of movement) or show resistance to instructions.

[ Read: Emotional Disorders In Children ]

v. Negative Symptoms:

Here, your little one will show symptoms that make it next to impossible for him to function normally. He may lack emotions of any type, refrain from making eye contact, not change his facial expressions or speak with emotions or inflection. This is also the phase where your child will not pay attention to his personal hygiene, withdraw socially, talk less and lose interest in everyday activities.

For your kid to have schizophrenia, he must have at least two or more of these symptoms. Of course, until the doctor says your child is schizophrenic, don’t take things for granted.

Child-Onset Schizophrenia:

Child-onset schizophrenia occurs in children aged 12 or younger. It is a severe form of the psychosis, and it is usually chronic and debilitating. After several decades of discussions, mental health care experts now agree that child onset schizophrenia is a highly severe version of schizophrenia that teens and adults develop.

Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by the American Psychiatric Association states that while the symptoms of schizophrenia during childhood are similar to those exhibited by adults and teenagers, the condition is tough to diagnose in children.

If your kiddo has child-onset schizophrenia, he will not experience as elaborate delusions and hallucinations as schizophrenic adolescents and adults. Rather, your child will have more visual hallucinations. Here, it is important that you learn to distinguish the hallucinations from childhood fantasy play.

Diagnostic Criteria For Child Onset Schizophrenia:

It is necessary the mental health care specialist first rules out other mental health issues before diagnosing schizophrenia. Your child should have a minimum of two symptoms for at least a month. Also, a few symptoms are mandatory.

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Negative symptoms
  • Catatonic behavior
  • Disorganized behavior

Health care experts state that for a child to have child-onset schizophrenia, it is important he have two of these symptoms along with delusions, disorganized speech or hallucinations. Other criteria for diagnosis include a significantly lower level of functioning at school, self-care, and interpersonal relations.

Prognosis Of Child Onset Schizophrenia:

The outcome of child-onset schizophrenia varies from child to child. Some kids tend to function normally with medication while others need a combination of drugs and psychotherapy.

Usually, the earlier a child develops schizophrenia, the poorer the outcome. It will prevent your child from attending school and completing his education. On the other hand, because children live in a family environment, usually you will be able to recognize the symptoms of child-onset schizophrenia early, thereby ensuring your child get the right treatment quickly.

Studies show that early diagnosis and treatment reduce issues related to functioning and long-term impairments that schizophrenics often experience [3].

Paranoid Schizophrenia In Children:

As the name suggests, paranoid schizophrenia causes intense thoughts and feelings of fear and anxiety because your child may think what he feels and thinks is true even though they are not. Usually, he will feel there is a conspiracy or some kind of threat to his person. These are delusions that your child has, and it will affect his thoughts and thinking. However, he will be able to function in everyday life. Before you shriek with happiness, let us inform you that these delusional thoughts will cause your little one to shun social settings. He will become limited in his life and will prefer staying in isolation because of his fear that someone or something is trying to hurt or kill him.

Signs Of Paranoid Schizophrenia In Children:

Some of the symptoms of paranoid schizophrenia in children include:

  • Delusions. This is perhaps the most common symptom of the disease. Your child will hold false beliefs that have nothing to do with reality. He might believe that he is being harmed or harassed, or certain comments are directed at him when they are not.
  • A sense of fear, mistrust and suspicion. These feeling are brought on by the delusions and the beliefs your child has. It will cause him to become extremely vigilant and adopt a defensive attitude.
  • Fear of being taken advantage of. This will completely do away with the ability to relax. It may also cause your child to become argumentative, as he may feel others around him are trying to take advantage of everything he says and does.

Symptoms of paranoid schizophrenia aren’t static or etched on stone. The disease can develop suddenly or gradually, but you can be certain that your child’s behavior will change over time. He may suddenly start talking about strange ideas and fear. You may notice your kid clinging to you or saying things that don’t make sense. If your child was previously social and outgoing, you might notice that he has become withdrawn, possibly living in his world.

[ Read: Mental Illness In Children ]

FAQs On Schizophrenia In Children:

As a parent, you may have many questions related to schizophrenia in children, especially if the disease runs in your family. So here are some frequently asked questions related to this disorder.

1. Can A Child Have Schizophrenia?

While it is very rare for a child to have schizophrenia, it is possible that your child can develop this disorder. Statistics show that about one in 40,000 children under the age of 18 gets diagnosed with schizophrenia [4].

While there is limited research on schizophrenia in children, research suggests that early onset of psychosis is common in middle or late adolescence. There is a prevalence rate of 1 percent among teens, whereas the prevalence rate for child-onset schizophrenia is 0.2 to 0.4 per 10,000 children [5].

2. Is Schizophrenia Hereditary In Children?

If it is some consolation, schizophrenia does not pass from one generation to another genetically since you cannot narrow down the cause to a single gene or specific cause for the illness. However, if there is schizophrenia in the family, your little one may have a predisposition for the disorder, but it does not mean that he will develop it.

Remember, schizophrenia is a complex interaction of genes, environment, and psychological factors. Researchers state that people with abnormal dopamine levels in the brain have a higher risk of developing schizophrenia. However, these levels along with other brain issues, such as problems with intra-brain connections called default mode network connectivity, together cause some change in the brain, leading to schizophrenia.

There seems to be a genetic component to schizophrenia. If a third-degree relative has schizophrenia, your child is twice as likely to develop the illness compared to a child who does not have such a relative.

If you or your partner has schizophrenia, there is a 10 percent chance that your child will develop the disorder [6]. However, genetics are not fate. Several other factors come into play to make a person schizophrenic, and these include behavior and environmental factors. Also, researchers still do not know which genes are responsible for schizophrenia. So, wondering whether hereditary plays a role in schizophrenia will do you no good. But knowing if your family has the condition does help.

“Knowing your family medical history can help the health professional you see to determine if you [or your little] should be offered medical screening that would not normally be conducted,” states Robin Bennett, a Genetics Counselor and Manager at Medical Genetics Clinics, University of Washington, Seattle.

3. Child Abuse And Schizophrenia:

Today, there is so much information about child abuse, especially childhood sexual abuse, and how it can cause lasting psychological damage. So many cases have emerged in recent times with adults claiming they were abused as children, and this has led to psychological illnesses, including schizophrenia and psychosis. So you may worry that your child has schizophrenia because he was abused.

There was a case in the UK, where a man in his 30s claimed that he was abused by a Catholic priest when he was a child, and this led to his schizophrenia. Based on evidence from expert psychiatrists, the judge presiding over the case accepted that the man was schizophrenic and attributed the sexual abuse in his childhood for his adult life psychiatric problems. This landmark case saw the British court awarding the man a large sum of money.

However, the amount of research on this topic is not conclusive. Hence, it would be impossible to state conclusively that child sexual abuse is a cause for schizophrenia. However, at the same time, researchers agree that it is impossible to rule out completely that the abuse could be a causal factor [7]. Researchers agree that serious trauma in childhood can lead to schizophrenia, and child sexual abuse is a common denominating factor among schizophrenics, but this does necessarily mean it is the cause of schizophrenia in children.

[ Read: Childhood Trauma ]

4. Can A Child Be Diagnosed With Schizophrenia?

As stated earlier, yes, your child can be diagnosed with schizophrenia. However, it is very rare for a child under 12 to have this illness. Usually, schizophrenia rears its head during mid or late adolescence.

Also, because the symptoms of schizophrenia in children are similar to autism and conduct disorder, many times the psychosis may be misdiagnosed or wrongly diagnosed. You need a knowledgeable and experienced psychiatrist to diagnose schizophrenia in your child, a specialist who knows the symptoms and able to ensure they are not related to any other behavioral disorder.

5. Can People With Schizophrenia Have Children?

This is a loaded question that does not have a right or wrong answer. Yes, people with schizophrenia can have children. There are cases of children growing up with a parent, who has the illness.

“Having a history of psychosis does not in itself prevent a woman from having a child,” states Paola Dazzan, a psychiatrist and specialist in schizophrenia associated with Bethlem Royal Hospital, London.

However, it is imperative that any woman in this situation discusses her plan to have a baby with her psychiatrist and seeks specialist advice. Some women will need to take medication during pregnancy, or will need admission to hospital after the baby arrives. In the most severe cases, the mother may not able to be the sole primary carer for her baby, and will need additional support,” states Dr. Dazzan.

This shows that people with schizophrenia do not always make healthy parents. Hence, if you or your loved one has schizophrenia, it is important you consult your psychiatrist, participate in support groups and take your medications diligently if you want to reduce your chances of relapse. This will allow you to be a better parent, albeit not perfect. But then, which parent is perfect?

If you want to get pregnant and have schizophrenia, consult your healthcare provider before you try getting pregnant.

In Conclusion:

If your child has schizophrenia, it will be devastating for you. However, make sure your child get early treatment as it improves prognosis. Also, join a support group of parents with schizophrenic children. This will let you see that you are not alone, and you will also be able to take tips from other parents when your child has negative symptoms. You will be better prepared to cope with your situation and support your child so that he gets an opportunity to lead a life, which wouldn’t be possible without the right treatment and your love and support.

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