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Childhood Schizophrenia

Definition


Disease: Childhood Schizophrenia Childhood Schizophrenia
Category: Psychiatric diseases
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Disease Definition:

Irrational behavior and thinking, delusions, hallucinations, and problems carrying out routine daily tasks, such as bathing, are all included in childhood schizophrenia. Special challenges for educational needs, diagnosis, treatment, and emotional and social development may be presented by the early age of onset with childhood schizophrenia. Early-onset schizophrenia or childhood-onset schizophrenia may be other names of childhood schizophrenia. It is sometimes combined with similar conditions known collectively as schizophrenia spectrum disorders.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Here are some of the signs and symptoms of childhood schizophrenia:

  • Strange eating rituals
  • Incoherent speech
  • Poor school performance
  • Having beliefs not based on reality (delusions)
  • Lack of emotion
  • Illogical thinking
  • Emotions inappropriate for the situation
  • Social withdrawal
  • Agitation
  • Seeing or hearing things that don't exist (hallucinations), especially voices
  • Decreased ability to practice self-care


Symptoms may be difficult to interpret:
Symptoms may build up gradually when childhood schizophrenia begins very early in life, maybe even at the age of 6, 7 or 8. The early signs and symptoms may be attributed to the developmental phase or they may not be really recognized as they could be so vague. However, the signs may become more severe and more noticeable to friends, family and school officials as time goes on. Difficulty with organizing thoughts, delusions and hallucinations are included in the symptoms of psychosis that the child may develop eventually. There's often a "break from reality" as thoughts become more disorganized. This stage of childhood schizophrenia often results in hospitalization and treatment with medications.

It might be hard to find a way to deal with vague behavioral changes in the child. Treatment at the first sign of a problem may help in the long run, though one may be afraid of rushing to conclusions that may lead to stigmatizing labels.

Medical advice should be sought when parents notice that their child has violent or aggressive behavior, is slipping in academic performance, has stopped meeting daily expectations, such as dressing or bathing, no longer wants to socialize, or has other signs and symptoms of a possible mental health disorder. It doesn't necessarily mean a child has childhood schizophrenia when having these general signs and symptoms, as they could simply include a phase of another condition, such as an anxiety disorder, a medical illness that requires other types of assessment and help, or depression.

Parents should seek medical care quickly when noticing that their child has a change in thinking, such as distortions in reality, disorganized thinking patters, or developing hallucinations, because these symptoms should be addressed as quickly as possible.

Causes:

It is though that childhood schizophrenia develops in the same way as adult schizophrenia does, though the cause of this condition is still not clear. The reason behind the onset of schizophrenia so early in life in some, though not in others, is also not known.

Brain dysfunction is suggested to be the cause of childhood schizophrenia and other forms of schizophrenia by a growing body of evidence. The reason and way that brain dysfunction occurs is still being studied. An interaction of environment and genetics is thought to cause this brain dysfunction. Schizophrenia may also be caused by problems with certain naturally occurring brain chemicals called neurotransmitters. There are differences in the brain structure of people with schizophrenia proved by imaging studies, but the significance of these changes is not really clear.

Researchers have identified the following factors that may be related to the risk of developing or causing schizophrenia:

 

  • Exposure to viruses while in the womb
  • Stressful early life circumstances
  • Taking psychoactive drugs during adolescence
  • Malnutrition while in the womb
  • Trauma or abuse during childhood
  • Older paternal age
  • Having a family history of schizophrenia

Complications

Complications:

Severe behavioral, health, emotional, and even legal and financial problems may be caused by childhood schizophrenia when it is left without treatment. Here are the complications that childhood schizophrenia may cause or be associated with:

  • Withdrawal from friends and family
  • Inability to perform daily activities, such as bathing or dressing
  • Declining school performance
  • Inability to attend school
  • Fights or arguments
  • Inability to live independently
  • Suicidal thoughts and behavior
  • Conduct problems
  • Self-destructive behavior

Treatments:

Lifelong treatment, even during periods when symptoms seem to have subsided, may be required in this condition, because it is a chronic one, lasting through adulthood. Though treatment is a particular challenge for children with schizophrenia, the treatment is similar for all types of schizophrenia.

Treatment Teams:
A psychiatrist skilled in treating schizophrenia in children usually guides childhood schizophrenia treatment. However, other professionals may be on the treatment team as well because the condition can affect so many areas of the child's life. The treatment team may help make sure that care is coordinated among all of the child's care providers and that the child is getting all of the treatment he/she needs.

A pediatrician or family doctor, psychiatrist, pharmacist, social worker, case worker, family members, psychiatric nurse, and a psychotherapist may be in the team that is involved in treatment of childhood schizophrenia.

Main treatment options:
Here are the main treatments for childhood schizophrenia:

  • Medications
  • Individual and family psychotherapy
  • Social and academic skills training
  • Hospitalization


MEDICATIONS FOR CHILDHOOD SCHIZOPHRENIA:
The most frequently used medications for treating schizophrenia in children are antipsychotic medications. The majority of medications used in children are the same as those used to treat adults with schizophrenia. Most of those medications are used off-label in children, which means that they haven't been specifically approved to treat children, and this is because these medications haven't been thoroughly tested in children. The common and legal practice of using a medication to treat an age group or a condition that is not really listed on its prescribing label as an approved use is referred to as off-label use.        
One should understand all the pros and cons of antipsychotic medication use in children because of the possibility of having serious side effects.

First-generations antipsychotics (conventional, or typical, antipsychotics):
The effectiveness of these antipsychotic medications is usually the same as that of the second-generation antipsychotics in controlling hallucinations and delusions. However, the increased possibility of tardive dyskinesia or involuntary movements of the hands, limbs, tongue and face, are included in the serious neurological side effects of these medications. Typical antipsychotics, generic versions in particular, usually cost less than second-generation antipsychotics. Nonetheless, they are usually not recommended for children until other options have been tried without success, because of their risk of serious side effects.

Second-generation antipsychotics (atypical antipsychotics):
Because these medications have fewer side effects, they are often tried first in children. To treat childhood schizophrenia in children ages 13 to 17, only two second-generation antipsychotics have been approved by the FDA; risperidone and aripiprazole.
For managing such symptoms as lack of emotion, delusions, hallucinations and loss of motivation, atypical antipsychotic medications are often effective. However, high cholesterol, diabetes and weight gain are among the serious side effects that these medications may cause.

Medication side effects and risks:
There are side effects and possible health risks, some even life-threatening, in all antipsychotic medications. Sometimes the side effects in children and adolescents may be more serious than those in adults, or they may not even be the same. Children, young ones in particular, may not have the ability to understand or communicate about medication problems.

All of the possible side effects and routine checks for health problems while the child takes these medications should be discussed with the child's doctor. Side effects should be reported to the doctor as soon as possible, and parents should be aware of problems in their child. The doctor may be able to adjust the dosage or change medications and limit side effects by spotting medications problems early. All of the family members could learn to manage side effects appropriately with the help of the child's doctor.

All medications and over-the-counter substances the child takes, including herbal supplements, minerals and vitamins should be discussed with the child's doctor, because antipsychotic medications can have dangerous interactions with other substances.

PSYCHOTHERAPY FOR CHILDHOOD SCHIZOPHRENIA:
Psychotherapy is important as well, even though the basis of childhood schizophrenia treatment is medications. The following may be included in psychotherapy:

Individual therapy:
The child may learn ways to cope with the distress and daily life challenges brought on by schizophrenia with the help of psychotherapy with a skilled mental health provider. School performance, communication skills and relationships may be improved, the severity of symptoms may be reduced, and the child may cope with stigma surrounding schizophrenia with the help of the therapy. The child may understand the importance of sticking to a treatment plan, coping with lingering symptoms and realizing the condition better when he/she learns about childhood schizophrenia. Cognitive behavioral therapy is among the many types of psychotherapy that may be useful.

Family therapy:
Therapy that provides support and education to families may be useful for both the child and the family. Children with schizophrenia may benefit in their ongoing recovery efforts with the help of involved, caring family members. Understanding family conflicts and a better communication between family members may be achieved with family therapy, which can reduce distress about the child's condition and help family members cope with it.

SOCIAL AND ACADEMIC SKILLS TRAINING FOR CHILDHOOD SCHIZOPHRENIA:
An important part of treatment for childhood schizophrenia is training in social and academic skills. Children with schizophrenia may have difficulty achieving normal daily tasks like dressing or bathing, and they often have troubled relationships and school problems. Treatment plans that are designed to deal with these problems may help, when possible, in giving the child the skills to function and live at age-appropriate levels.

HOSPITALIZATION FOR CHILDHOOD SCHIZOPHRENIA:
Hospitalization may be necessary during crisis periods or times of severe symptoms. Sometimes the hospital setting is the safest and best way to get symptoms under control quickly, which is very important in childhood schizophrenia. So the child's safety and that of others may be ensured by the help of hospitalization, which can make sure that the child is getting proper hygiene, sleep and nutrition. Symptoms are usually more stabilized before moving to partial hospitalization or residential care, which may also be options.

Prognosis:

Not Available

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