Childhood schizophrenia
[4][6] The disorder presents symptoms such as auditory and visual hallucinations, delusional thoughts or feelings, and abnormal behavior, profoundly impacting the child's ability to function and sustain normal interpersonal relationships.
[7] Among the psychotic symptoms seen in childhood schizophrenia, non-verbal auditory hallucinations are the most common, and include noises such as shots, knocks, and bangs.
[citation needed] Other symptoms can include irritability, searching for imaginary objects, low performance, and a higher rate of tactile hallucinations compared to adult schizophrenia.
The diagnosis is based on thorough history and exam by a child psychiatrist, exclusion of medical causes of psychosis (often by extensive testing), observations by caregivers and schools, and in some cases (depending on age) self reports from pediatric patients.
Some children engage in activities such as flapping the arms or rocking, and may appear anxious, confused, or disruptive on a regular basis.
The cognitive abilities of children with schizophrenia may also often be lacking, with 20% of patients showing borderline or full intellectual disability.
[20] Negative symptoms include apathy, avolition, alogia, anhedonia, asociality, and blunted emotional affect.
The prodromal phase, which precedes psychotic symptoms, is characterized by deterioration in school performance, social withdrawal, disorganized or unusual behavior, a decreased ability to perform daily activities, a deterioration in self-care skills, bizarre hygiene and eating behaviors, changes in affect, a lack of impulse control, hostility and aggression, and lethargy.
Children often attribute the hallucinatory voices to a variety of beings, including family members or other people, evil forces ("the Devil", "a witch", "a spirit"), animals, characters from horror movies (Bloody Mary, Freddy Krueger) and less clearly recognizable sources ("bad things," "the whispers").
[citation needed] Several environmental factors, including perinatal complications and prenatal maternal infections may contribute to the etiology of schizophrenia.
[25] Severity or frequency of prenatal infections may also contribute to earlier onset of symptoms by means of congenital brain malformations, reduction or impairment of cognitive function, and psychological disorders.
[25] Genetic predisposition is an important factor as well; familial mental illness is more frequently reported for childhood-onset schizophrenic patients.
[29] There have been several genes indicated in children diagnosed with schizophrenia that include: neuregulin, dysbindin, D-amino acid oxidase, proline dehydrogenase, catechol-Omethyltransferase, and regulator of G protein signaling.
[34][35] Studies have reported that adverse childhood experiences (ACEs) are the most preventable cause of the development of psychiatric disorders such as schizophrenia.
The DSM diagnostic criteria outlines that the person has to be experiencing either delusions, hallucinations, or disorganized speech.
[43] DSM-5 also recommends that a better distinction be made between a current condition of schizophrenia and its historical progress, to achieve a clearer overall characterization.
A professional who believes a child has schizophrenia usually conducts a series of tests to rule out other causes of behavior, and pinpoint a diagnosis.
Physical exams usually cover the basic assessments, including but not limited to; height, weight, blood pressure, and checking all vital signs to make sure the child is healthy.
BD, ASD, and ADHD overlap with symptom patterns in CS [53] but a few distinguishing factors helps differentiate the disorders.
Individuals with bipolar disorder and childhood schizophrenia can both present psychotic symptoms such as hallucinations, delusions, and disorganized behaviors.
[53] A distinguishing feature in childhood schizophrenia, the hallucination, aren't taking place during a 'depressive or manic' episode as it would for an individual diagnosed with bipolar disorder.
[53] Autism spectrum disorder share many features that are present in CS such as disorganized speech, social deficits, and extremely bizarre and repetitive behaviors.
[53] Research efforts are focusing on prevention in identifying early signs from relatives with associated disorders similar to schizophrenia and those with prenatal and birth complications.
Contemporary practices of schizophrenia treatment are multidisciplinary, recuperation oriented, and consist of medications, with psychosocial interventions that include familial support systems.
[58] A 2013 systematic review compared the efficacy of atypical antipsychotics versus typical antipsychotics for adolescents: Madaan et al. wrote that studies report efficacy of typical neuroleptics such as thioridazine, thiothixene, loxapine and haloperidol, high incidence of side effects such as extrapyramidal symptoms, akathisia, dystonias, sedation, elevated prolactin, tardive dyskinesia.
Regardless of treatment, children diagnosed with schizophrenia at an early age have diminished social skills, such as educational and vocational abilities.
[62] The grey matter in the cerebral cortex of the brain shrinks over time in people with schizophrenia; the question of whether antipsychotic medication exacerbates or causes this has been controversial.
[69] In 1909, Julius Raecke reported on ten cases of catatonia in children at the Psychiatric and Neurological Hospital of Kiel University, where he worked.
He described symptoms similar to those previously recorded by Dr. Karl Ludwig Kahlbaum, including "stereotypies and bizarre urges, impulsive motor eruptions and blind apathy.
"[68] He also reported refusal to eat, stupor with mutism, uncleanliness, indications of waxy flexibility and unmotivated eccentricity, and childish behavior.
