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Childhood Schizophrenia
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Schizophrenia is a lifelong, incapacitating mental disorder that makes it difficult to recognize between real and imaginary events.
People with schizophrenia sometimes hear voices while others don’t hear any, they may imagine that people are reading their
minds, controlling their thoughts, or plotting to harm them. These experiences can make them nervous and distracted and
create difficulties when attempting to build relationships with others. These situations are upsetting and may cause fearfulness,
withdrawal, or extreme frustration. People with schizophrenia may not make sense when they speak, may sit for hours without
moving or talking much, or may seem perfectly fine until they talk about what they are truly thinking. Consequently, the way
they communicate and behave often appears to be unbalanced, irrational, antisocial, delusional and/or paranoid.

Schizophrenia can occur at any age affecting an estimated 1 in 40,000 children under the age of 13. During early teen years, the
rate of schizophrenia onset in the general population begins to increase, and the peak rates of onset fall between the ages of 15
and 30. Males tend to experience the first signs and symptoms of schizophrenia at the younger end of this range, while onset in
females is usually at the older end. While childhood schizophrenia is basically the same brain disorder as schizophrenia in adults,
the early age of onset suggests special considerations for diagnosis, treatment, educational needs, emotional and social
development, family relationships, and other issues.

Although there's no cure for schizophrenia, medications and individualized mental health care services can help families manage
the disorder, learn strategies to cope with the effects of childhood schizophrenia, and address other child and adolescent
developmental needs. Studies find that children share with adults many of the same abnormal brain structural and
neuropsychological features associated with schizophrenia. In addition, children seem to have more severe cases than adults,
with more pronounced neurological abnormalities.

Common Symptoms of Childhood Schizophrenia

When childhood schizophrenia begins very early, the disorder often becomes apparent gradually and builds up to the first
psychotic episode. Early signs of the disorder may include social withdrawal, disruptive behaviors, learning difficulties, speech
or language impairments, or other developmental delays. These early signs aren't specific to childhood schizophrenia and may
indicate a variety of other conditions.

In adolescents, schizophrenia may also begin gradually, but the unexpected start of psychotic symptoms and decline in hygiene
and functioning is more common in this age group than in younger children. Although very young children can start showing
signs of schizophrenia, it's extremely rare to get an official diagnosis before a child is 7 years old. Children with childhood
schizophrenia often have hallucinations in the form of sounds, voices, images, odors, or tastes things that do not really exist.
Other symptoms these children may encounter include:

•        Problems paying attention
•        Impaired speech
•        Difficulty with memory and reasoning
•        Absent or inappropriate facial expression of emotion
•        Poor social and self care skills
•        Depressed mood, thoughts, and feelings
•        Inability to make decisions
•        Inconsistent body movements
•        Believing in make-believe ideas about reality
•        Hearing voices or experiencing other sensory incidents that aren't real (hallucinations)
•        Disorganized thinking
•        Excessive motions with no purpose
•        Little verbal communication with other people

Children with childhood schizophrenia many times may show few or no feelings; they may laugh at a sad occasion, make poor
eye contact, and show little body language. It is important to remember that as children grow, they naturally have frequent
mood and behavior changes that are a part of their normal growth and development. Only an evaluation by a mental health
professional can determine if a child is developing childhood schizophrenia.

Types of Schizophrenia

Paranoid-type schizophrenia is described by delusions and auditory hallucinations but have fairly normal intellectual
functioning and expression for concern. The delusions can often be about being victimized unjustly or being some other person
who is famous. People with paranoid-type schizophrenia can exhibit anger, unfriendliness, anxiety, and become confrontational.

Disorganized-type schizophrenia is described by speech and behavior that is delirious or difficult to understand, and empty or
improper emotions. People with disorganized-type schizophrenia may laugh at insignificant incidents or at something not closely
related to what they are saying or doing. Their disorganized behavior may disrupt daily activities, such as showering, dressing,
and preparing meals.

Catatonic-type schizophrenia is described by disturbances of movement. People with catatonic-type schizophrenia may keep
themselves completely motionless or constantly in motion. They may not say anything for hours, or they may repeat anything
you say or do senselessly. Either way, the behavior is puts this form as high risk because it impairs their ability to take care of

Undifferentiated-type schizophrenia is described by some symptoms seen in all of the above types but not enough of any
one of them to classify it as a specific type of schizophrenia.

Residual-type schizophrenia is described by a past history of at least one episode of schizophrenia, but the person currently
has no active symptoms (delusions, hallucinations, erratic speech or behavior). It may signify the person is in between an actual
episode and possibly complete remission, or schizophrenia may continue for years without any further psychotic episodes.

Most importantly Schizophrenia does not mean split personality.

Schizophrenia Possible Causes

There is no precise cause for the disorder. Scientists do not yet understand what causes schizophrenia, but believe it may be a
combination of genes, environment, behavior, and other factors. Researchers are investigating all of these factors to learn the
cause. Most researchers believe that schizophrenia results from problems with early brain development.

Studies have focused on the way brain cells communicate with each other through nerve pathways. Too many or too few
connections in the vital pathways of emotional directing may lead to psychotic symptoms. More specifically, certain areas of
the brain that are rich in the chemical dopamine (compounds that function as neurotransmitter found in the brain and essential
for the normal functioning of the central nervous system) seem to be affected frequently in schizophrenia.

The reasons associated with the development of these brain-pathway problems are controversial and are being carefully
investigated. Some of the areas of current research include the possibility of related genes and stressful childhood environments
in genetically susceptible children. If a parent has schizophrenia, the chance for a child to have the disorder is 10 to 15 percent.
Risks increase with multiple affected family members.

Schizophrenia and Hereditary

Scientists have long known that schizophrenia has a genetic predisposition. It occurs in 1 percent of the general population but
is seen in 10 percent of people with first-degree family members (a parent, brother, or sister) with the disorder. People who
have second-degree relatives (aunts, uncles, grandparents, or cousins) with the disorder also develop schizophrenia more often
than the general population. The identical twin of a person with schizophrenia is most at risk, with a 40 to 65 percent chance of
developing the disorder.

People who have a close relative with schizophrenia are more likely to develop the disorder than people who do not have a
relative with the illness. The risk of schizophrenia in the general population is about 1%. Scientists think that there are several
genes that may make a person more likely to develop schizophrenia. Environmental factors, such as prenatal illness or birth
complications, may also influence the development of schizophrenia. Even with this information, doctors are not yet able to
predict who will develop the illness.

Although there is a genetic risk for schizophrenia, it is not likely that genes alone are sufficient to cause the disorder.
Interactions between genes and the environment are thought to be necessary for schizophrenia to develop. Many environmental
factors have been suggested as risk factors, such as exposure to viruses or malnutrition in the womb, problems during birth,
social/emotional, psychological behaviors, and circumstances like stressful environmental conditions.

Childhood Schizophrenia Evaluation

Parents concerned that their child is experiencing two or more symptoms of childhood schizophrenia and he/she is having
difficulty in daily living in areas such as school, friendships, and self-care, they should contact the child's pediatrician or family
doctor for a physical exam. An assessment can help rule out the possibility of a child having another disorder with similar
symptoms. This is usually done before a doctor refers a child for an evaluation by a mental health professional specifically
trained and skilled at evaluating, diagnosing, and treating children and adolescents with mental health disorders.

The child’s doctor will most likely refer you to a psychiatrist for evaluation. A complete diagnostic check-up will include:

•        A complete medical, social and family history.
•        Interviews with the child and parents or guardians to review any possible psychotic symptoms, changes in behavior and
the chance of other psychiatric disorders.
•        Testing to evaluate cognitive skills and functional abilities in daily life.
•        A review of school records or other contributions from school staff.
•        Blood and brain-imaging tests to rule out additional medical conditions.

This process takes time. The psychiatrist will make a diagnosis of schizophrenia only if psychotic behaviors and other
diagnostic criteria continue for at least six months, and no other causes for the signs and symptoms have been found.

During that time the doctor should know about all behaviors observed, and any thoughts the child may express. For example,
your psychiatrist will want to know whether problems occur only at home or at school or whether they're appear in all settings.
He or she will inquire about many educational, personal, domestic and social aspects that may contribute to your child's

Diagnostic challenges

Childhood schizophrenia is difficult to diagnose for a number of reasons. Because it's rare, doctors not specializing in pediatric
psychiatry may have limited knowledge with diagnosing schizophrenia in younger people.

Behaviors or thoughts that may seem related to delusions or hallucinations may simply be the result of a lively imagination,
especially in younger children. However, these behaviors or thoughts should normally not cause impairment.

Some signs and symptoms of schizophrenia are similar to those of other mental health or developmental disorders. In fact, the
psychiatrist will want to rule out these disorders before making a diagnosis of schizophrenia:

•        Bipolar disorder
•        Schizoaffective disorder, a form of both schizophrenia and mood disorder
•        Severe anxiety disorders
•        Severe major depression with psychotic features
•        Post-traumatic stress disorder
•        Substance abuse disorders (particularly cocaine and methamphetamine)
•        Delusional disorders
•        Medical disorders that affect the brain
•        Personality disorders
•        Autism spectrum disorders

Treatment for Childhood Schizophrenia

Treatment types for childhood schizophrenia are based mostly on adult treatments and interventions, which have been studied
more thoroughly. Medications known as atypical anti-psychotics are the foundation of treatment. These medications help to
control psychotic behaviors through regulation of dopamine associated nerve pathways. These drugs may prevent the
recurrence or lessen the intensity of psychotic episodes.

A child's first experience with a psychotic incident can be very frightening and disturbing. While there may be much to learn
about your child's condition over the course of several months, dealing with the immediate crisis of a psychotic episode is

Other Forms of Therapy for Schizophrenia

Other interventions for childhood schizophrenia intended to be used along with drug treatment may include:

•        Ongoing, age appropriate education about the disorder and treatment options for both the child and family members,
including siblings.

•        Social skills and basic life skills training at home, school and in the community.

•        Psychotherapy for child and parents or guardians that focuses on coping strategies, problem-solving skills, and
awareness of symptoms and the circumstances that may prompt or aggravate them.

•        Special educational programs that address learning and developmental needs.

•        Day programs or at-home services for children who can't attend school for an entire day.

It's important to report any visible medication side effects to your doctor immediately. By detecting medication problems early,
your physician can adjust dosing or brand of prescription. Hospitalization may be necessary when psychotic behaviors aren't
effectively managed by drug treatment or when behaviors, particularly paranoid delusions or hallucinations, present a danger to
the child or others; parents may have reason for concern if their child who is 7 years or older is experiencing these behaviors.
Such behaviors could be symptoms of childhood schizophrenia.

Schizophrenia is a mental health disorder that currently has no cure and will not disappear, but its symptoms are manageable
with treatment. Treatment for schizophrenia includes biological, educational, and social