Childhood Schizophrenia

Childhood schizophrenia is a type of mental disorder that is characterized by alteration of thinking, motor, and emotional processes in children and young adults under the age of 18. In this, the children interpret reality abnormally. Schizophrenia affects the child’s thinking, behavior, or emotions. It is rare in children under 8yrs of age. The condition can become life-threatening if unnoticed as the child can harm themselves. It can be treated effectively in the early stage.

Although there is no known cause, a number of factors, including brain diseases, genetics, environment, issues with neurotransmitters, and differences in the brain, can have a significant impact on how childhood schizophrenia develops. A child is more likely to develop schizophrenia if there is a family history of the disease, the mother was exposed to viruses, toxins, or malnutrition while she was pregnant, the immune system was abnormally activated, the father is older, and the mother had a history of using psychoactive drugs when she was a teenager.

Early diagnosis and treatment of the child are more crucial because if they are not, they may experience depression and consider suicide. The diagnosis is made based on the history of the symptoms, a physical exam, a psychological evaluation, and any necessary investigations.

Childhood Schizophrenia: Causes

Various factors play an important role in the development of childhood schizophrenia, which include −

• Genetics − It has been seen that schizophrenia runs in families. Children with a parent or sibling with the disorder are at an increased risk of developing the condition.

• Any abnormalities in the development of the brain can also result in childhood schizophrenia as there can be any structural abnormality of the brain affecting the various functional areas of the brain.

• Imbalances in certain neurotransmitters, such as dopamine and glutamate, are also known to cause the disease.

• Exposure to the various toxins by the mother during pregnancy, any complications during the birth of a child.

• Children with poor socioeconomic status, social isolation, poverty, and trauma during childhood can also affect the thinking of the child.

• Some studies have suggested that dysfunction of the immune system may play a role in the development of schizophrenia.

Childhood Schizophrenia: Symptoms

The child mainly presents with behavioral or emotional changes which vary from reality. the diagnosis is based on the symptoms of the child. These include −

• Delusions − The affected child has false beliefs that are not present in reality. The child may feel that someone is trying to harm them or that they have got a special power or ability.

• Hallucinations − Hallucinations are perceptions that are not present in the reality. The child may see, hear, or feel things that are not there.

• Behavioral issues − The child may present aggressive behavior, such as throwing tantrums, breaking things, or physically attacking others.

• Disorganized speech and thoughts − The child faces difficulty in organizing their thoughts and expressing themselves coherently. The child may not be able to concentrate on a particular topic or may face difficulty in making logical connections between ideas.

• Emotional disturbances − The child’s emotional response may not match the situation. Sudden outbursts of emotion can be present, such as laughing or crying for no specific reason.

• Social withdrawal − The child may be seen alone and they may have difficulty making friends and engaging in social activities.

• Poor academic performance − the child may struggle with reading, writing, and calculating. They may not pay attention and concentrate in school.

Childhood Schizophrenia: Risk Factors

Various factors play role in increasing the risk of development of childhood schizophrenia which include −

• The child with a family history of schizophrenia. children with a parent or sibling with the disorder are at an increased risk of developing the condition Studies

• Exposure to viruses, toxins, or malnutrition of the mother during pregnancy. Any complications occurring during the birth of the child

• Abnormal activation of the immune system

• Stressful events during childhood, such as abuse, neglect, or trauma

• Older age of the father

• Taking psychoactive drugs during teen years

• Children with poor socioeconomic status, social isolation, and poverty.

Childhood Schizophrenia: Diagnosis

The diagnosis of childhood schizophrenia is typically based on a thorough clinical evaluation and assessment of the patient's symptoms and medical history.

• Diagnostic criteria are given according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

• According to this criterion, at least two of the following symptoms should be present, which include −

• Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms (such as flat affect or social withdrawal). In addition, the patient must experience significant impairment in their daily functioning for at least six months.

• Clinical Examination − This is necessary to rule out any underlying medical conditions that could be causing the patient's symptoms. It is important to ask about the patient's family and medical history, as well as any medications they are taking. The behavior of the child at school and home should be asked.

• Psychological evaluation − Neuropsychological testing should be done to assess cognitive abilities and identify any deficits that may be present. Observe the appearance of the child. Asking about thoughts, feelings, and behavior patterns, talking to a child about any thoughts of self-harm or harming others, evaluating the ability to think and function at an age-appropriate level, and Assessing mood, anxiety, and possible psychotic symptoms should be done.

• Blood tests, Imaging studies, such as magnetic resonance imaging (MRI) or computerized tomography (CT), and Electroencephalogram (EEG) can be advised in some of the children if required.

Childhood Schizophrenia: Treatment

The treatment of childhood schizophrenia involves −

• Pharmacological therapy − Antipsychotic medications can help the child to reduce the severity of symptoms and improve overall functioning.

• Psychotherapy − Cognitive behavioral therapy (CBT) can help the child identify and improve their thoughts, and beliefs, and improve coping skills. Family support can also help the child in improving communication and reducing stress within the family.

• Vocational training and social skills training can also be required in some children.

• Educating the parents and caregivers about the support to manage the child's symptoms and provide ongoing care.

Childhood Schizophrenia: Prevention

There are no measures to prevent childhood schizophrenia, but some of the factors can reduce the risk of developing schizophrenia in childhood that include −

• Regular prenatal care, eating a healthy diet, and avoiding alcohol, drugs, and tobacco during pregnancy.

• Early diagnosis and treatment of mental health disorders in childhood should be done

• Providing a safe and supportive home environment during stressful events during childhood, such as abuse, neglect, or trauma, has been known to the increase risk of schizophrenia.

• Following a healthy diet, regular exercise, and getting adequate sleep should be advised to a child

• Substance abuse should be avoided particularly during adolescence

Conclusion

Childhood schizophrenia is a psychological disorder in which there is a severe brain disorder in which the children interpret reality abnormally. It affects the child’s behavior or emotion. The child may present with delusions, hallucinations, and abnormal behavior, and usually stays separated from friends and any activities.

There is no exact cause known but genetic, brain abnormalities, and defects in some of the neurotransmitters have been known to play a role. Early identification and intervention of the condition are very important as the child can harm themselves if left untreated. There are no preventive measures to stop the occurrence of the disease but some of the measures can help to reduce the risk of developing the disease.