Pediatric schizophrenia
Encyclopedia
Pediatric schizophrenia is a type of mental disorder that is characterized by degeneration of thinking, motor, and emotional processes in children and young adults under the age of 18. Patients are unable to distinguish between what is real and what is not; the disease is illustrated by symptoms such as auditory and visual hallucinations, strange thoughts/feelings, and abnormal behavior therefore profoundly impacting the child’s ability to function and sustain normal interpersonal relationships. Schizophrenia is especially rare in children under the ages of 7-8 years old . About 50% of young children diagnosed with schizophrenia will experience severe neuropsychiatric symptoms. . Diagnostic criteria are similar to that of adult schizophrenia, however there are differentiating characteristics between the two. Diagnosis is based on observed behavior by caretakers and in some cases depending on age, self reports. It is important to note that diagnosis can only be made by a psychiatrist and licensed psychologist.
Schizophrenia has no definite cause, however, certain risk factors seem to correlate. Suggestions of causes combine multiple factors, not just one, that could contribute to the onset of the disease. Genetics play a large part in patients with schizophrenia, with higher rates found in children of schizophrenics. There is no known cure but childhood schizophrenia is controllable with the help of the proper fusion of behavioral therapies and medications.
By the 1960’s, “childhood schizophrenia” became known as a “heterogeneous mixture” of different diseases, such as autism, symbiotic psychosis, dementia infantilis, etc. Childhood schizophrenia was not directly added to the DSM until 1980 in the DSM-III, which included similar diagnostic criteria as adult schizophrenia .
Positive symptoms are usually easier to treat than negative symptoms and are easier to sustain a better quality of life.
, version DSM-IV is the standardized manual used in the United States to diagnose mental disorders. The criteria used to diagnose the disorder is as follows:
Two or more of the following symptoms present for a significant portion of time during a one-month period.
If the symptoms last for a six-month period, further assessments by medical professionals should be done.
exams and brain imaging scans. Blood tests are used to rule out alcohol or drug effects being a factor.
or psychiatrist
will talk to a child about their thoughts, feelings and behavior patterns and ask about how severe the symptoms are and the effect they have on daily life. Thoughts of suicide or self-harm may also be discussed in these one-on-one exams. School records may be requested and questioners are used to assess anxiety and mood. All will be evaluated on an age appropriate level.
These alone do not cause schizophrenia. There needs to be some kind of genetic predisposition coupled with these factors.
and schizophrenia is seemingly strong. Many believe that changes in neo-natal development cause the disorder while others believe it is hereditary, but neither have concrete support. If neither parent has the disorder there is a 1% chance that a child will develop it but the chances increase to 10% if one parent has schizophrenia. Possible genetic causes may be:
consists techniques for treating mental health and some psychiatric disorders. It helps patients understand what helps them feel positive or anxious, as well as accepting their strengths and weaknesses. On an individual basis, the patient learns about their disorder and learns to cope with persistent symptoms. Psychotherapy also helps the patient surmount the negative connotation associated with schizophrenia.
The stages of development as defined by Erik Erikson (internal link) would increase the need for psychotherapy as well as family therapy . The parents here can increase their bond with the child and possibly increase the chance of recovery. Children with schizophrenia may never be rid of their symptoms completely, but treatments are in place to assist with coping.
The following statistics were gathered from E. Torrey in “Surviving Schizophrenia”:
After 10 years, of the people diagnosed with schizophrenia:
25% Completely Recover;
25% Much Improved, relatively independent;
25% Improved, but require extensive support networks;
15% Hospitalization, unimproved;
10% Dead (Mostly Suicide)
After 30 years, of the people diagnosed with schizophrenia:
25% Completely Recover;
35% Much Improved, relatively independent;
15% Improved but require extensive support network;
10% Hospitalized, unimproved;
15% Dead (Mostly Suicide) .
Schizophrenia has no definite cause, however, certain risk factors seem to correlate. Suggestions of causes combine multiple factors, not just one, that could contribute to the onset of the disease. Genetics play a large part in patients with schizophrenia, with higher rates found in children of schizophrenics. There is no known cure but childhood schizophrenia is controllable with the help of the proper fusion of behavioral therapies and medications.
History
Schizophrenic disorders are rare, especially in children. Only 4% of children fifteen and under are affected, and 0.1-1% is affected under the age of ten . People have been and still are reluctant to diagnose schizophrenia early on, primarily due to the stigma attached to it . Until the late nineteenth century, children were often not found to be suffering from psychosis like schizophrenia, but instead said to be suffering from “pubescent” or “developmental” insanity. Through the 1950’s, childhood psychosis began to become more and more common, and psychiatrists began to take a deeper look into the issue .By the 1960’s, “childhood schizophrenia” became known as a “heterogeneous mixture” of different diseases, such as autism, symbiotic psychosis, dementia infantilis, etc. Childhood schizophrenia was not directly added to the DSM until 1980 in the DSM-III, which included similar diagnostic criteria as adult schizophrenia .
Signs and symptoms
Signs are physical states that others can see and observe while symptoms are something that a third party is unaware of but the patient describes. When children develop Schizophrenia very early in life, their signs seem to be a possible developmental phase and start off small and insignificant. As the disorder progresses, children will begin showing signs of psychosis and experiencing symptoms such as, but not limited to, delusions, hallucinations and disorganized thoughts. As the symptoms become more severe, a break from reality occurs and this is when medical attention is needed.Negative symptoms
The term “negative symptom” is used to describe a normal function that most people have which are not present in a schizophrenic patient. These symptoms include- Lack of motivation
- Lack of emotion
- Social withdrawal
- Inability to take care of oneself
- Poor school performance.
Positive symptoms
As the counterpart to negative symptoms, positive symptoms are described as being present in a schizophrenic patient while not present in non-patients. These include:- Seeing or hearing things, especially voices, that do not exist (HallucinationHallucinationA hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid,...
s) - Having beliefs that are not based in reality (DelusionDelusionA delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...
s) - Having inappropriate emotions to certain situations
- Being easily agitated
- Illogical thinking and incoherent speech
- Strange eating habits
Positive symptoms are usually easier to treat than negative symptoms and are easier to sustain a better quality of life.
Diagnosis
Diagnosis is based on reports by parents/caretakers, teachers, school officials and others close to the child. If any abnormalities in behavior are present, psychiatrists or other professionals in the mental health fields do a further assessment. Diagnosis is usually more challenging when it pertains to children rather than adultsCriteria
The Diagnostic and Statistical Manual of Mental DisordersDiagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
, version DSM-IV is the standardized manual used in the United States to diagnose mental disorders. The criteria used to diagnose the disorder is as follows:
Two or more of the following symptoms present for a significant portion of time during a one-month period.
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized behavior
- Social dysfunction (interpersonal or academic achievement)
If the symptoms last for a six-month period, further assessments by medical professionals should be done.
Diagnostic examinations
If a professional believes that a child has schizophrenia, a series of tests are usually performed in order to rule out other causes of behavior and pinpoint a diagnosis. Two different types of tests are used; laboratory and psychological.Laboratory
Physical exams alone cannot completely diagnose schizophrenia, but they do help rule out other diseases that can be causing the behavior. Doctors may run tests on the brain to see if any abnormalities exist. Some tests include EEGEEG
EEG commonly refers to electroencephalography, a measurement of the electrical activity of the brain.EEG may also refer to:* Emperor Entertainment Group, a Hong Kong-based entertainment company...
exams and brain imaging scans. Blood tests are used to rule out alcohol or drug effects being a factor.
Psychological
A psychologistPsychologist
Psychologist is a professional or academic title used by individuals who are either:* Clinical professionals who work with patients in a variety of therapeutic contexts .* Scientists conducting psychological research or teaching psychology in a college...
or psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
will talk to a child about their thoughts, feelings and behavior patterns and ask about how severe the symptoms are and the effect they have on daily life. Thoughts of suicide or self-harm may also be discussed in these one-on-one exams. School records may be requested and questioners are used to assess anxiety and mood. All will be evaluated on an age appropriate level.
Possible causes
Evidence suggests that there is a large hereditary component with schizophrenia. Research proposes that schizophrenia is caused by genetic vulnerability coupled with environmental stressors.Environmental causes
Environmental causes will be described as any factor that is not genetic or hereditary (any macro-factor). Some possible environmental risk factors comprise of:- Disturbed family/ interpersonal problems
- Being from a low-class household/poverty
- Inadequate social resources
These alone do not cause schizophrenia. There needs to be some kind of genetic predisposition coupled with these factors.
Genetic causes
The link between geneticsGenetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
and schizophrenia is seemingly strong. Many believe that changes in neo-natal development cause the disorder while others believe it is hereditary, but neither have concrete support. If neither parent has the disorder there is a 1% chance that a child will develop it but the chances increase to 10% if one parent has schizophrenia. Possible genetic causes may be:
- Family history of the disorder
- Exposure to viruses in the womb
- Prenatal malnutrition
- Certain drugs
- Stressful situation early in life
Treatment
Childhood schizophrenia is chronic and children with schizophrenia require permanent treatment. Treatment is the same for all forms of schizophrenia. However, because childhood is such a molding period, treatment can be a challenge.Medications
Most medications used for childhood schizophrenia are the same as the ones used for adult schizophrenia, with antipsychotics being the most important step in treatment. Some drugs that may be used include but are not limited to- RisperidoneRisperidoneRisperidone is a second generation or atypical antipsychotic, sold under the trade name . It is used to treat schizophrenia , schizoaffective disorder, the mixed and manic states associated with bipolar disorder, and irritability in people with autism...
(Risperdal) - AripiprazoleAripiprazoleAripiprazole is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression...
(Abilify)
Psychotherapy
PsychotherapyPsychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
consists techniques for treating mental health and some psychiatric disorders. It helps patients understand what helps them feel positive or anxious, as well as accepting their strengths and weaknesses. On an individual basis, the patient learns about their disorder and learns to cope with persistent symptoms. Psychotherapy also helps the patient surmount the negative connotation associated with schizophrenia.
Prospective Outlook
The primary area that children with schizophrenia must adapt to is their social surroundings. It has been found, however, that early-onset schizophrenia carried a more severe prognosis than later-onset schizophrenia. Regardless of treatment, children diagnosed with schizophrenia at an early age suffer diminished social skills, such as educational and vocational abilities . A study also found social disability in the group with onset before age twelve is significantly greater than those 13-18 at age of onset . Psychotherapy is used in order to assist those with schizophrenia understand their disorder and learn to thrive socially with it .The stages of development as defined by Erik Erikson (internal link) would increase the need for psychotherapy as well as family therapy . The parents here can increase their bond with the child and possibly increase the chance of recovery. Children with schizophrenia may never be rid of their symptoms completely, but treatments are in place to assist with coping.
The following statistics were gathered from E. Torrey in “Surviving Schizophrenia”:
After 10 years, of the people diagnosed with schizophrenia:
25% Completely Recover;
25% Much Improved, relatively independent;
25% Improved, but require extensive support networks;
15% Hospitalization, unimproved;
10% Dead (Mostly Suicide)
After 30 years, of the people diagnosed with schizophrenia:
25% Completely Recover;
35% Much Improved, relatively independent;
15% Improved but require extensive support network;
10% Hospitalized, unimproved;
15% Dead (Mostly Suicide) .