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Schizophrenia in Children and Adolescents

By Josephine Elia, MD, Professor of Psychiatry and Human Behavior, Professor of Pediatrics;Attending Physician, Sidney Kimmel Medical College of Thomas Jefferson University;Nemours/A.I. duPont Hospital for Children

(See also Schizophrenia in adults.)

Schizophrenia is a chronic disorder involving abnormal thoughts, perceptions, and social behavior and causing considerable problems with relationships and functioning. It lasts 6 months or more.

  • Schizophrenia is probably caused by chemical abnormalities in the brain and by problems during the brain’s development.

  • Adolescents withdraw, start having unusual emotions, and usually have hallucinations, delusions, and paranoia.

  • Doctors do tests to rule out other possible causes.

  • Antipsychotic drugs can help control symptoms, and counseling can help adolescents and family members learn how to manage the disorder.

Schizophrenia is quite rare in childhood, before adolescence. It typically begins anytime from mid-adolescence to a person's mid-30s, most often during a person's mid-20s.

Schizophrenia probably occurs because of chemical abnormalities in the brain and problems during the brain’s development, which occur during pregnancy and early childhood. Doctors do not know exactly what causes these abnormalities.

However, experts agree that people can inherit a tendency to develop schizophrenia and that it is not caused by poor parenting or difficulties during childhood.

Symptoms

Like adults with schizophrenia, children and adolescents are likely to have

  • Hallucinations

  • Delusions (false beliefs usually involving a misinterpretation of perceptions or experiences)

  • Paranoia, often fearing that others are planning to harm them or are controlling their thoughts

In children, symptoms are likely to start more gradually and to become more severe than in adolescents or adults. Also, thinking is more likely to be impaired.

Adolescents may withdraw, start having unusual emotions, and/or have hallucinations, delusions, and paranoia.

Diagnosis

  • Evaluation of symptoms over time

  • Tests to rule out other disorders

There is no specific diagnostic test for schizophrenia. Doctors base the diagnosis on a thorough evaluation of symptoms over time.

Doctors also do tests to check for other conditions that can cause similar symptoms. Such conditions include brain infections, injuries, tumors, autoimmune disorders, and use of certain drugs (such as corticosteroids and many illicit drugs).

Did You Know...

  • Schizophrenia should not be blamed on poor parenting or difficulties during childhood.

Treatment

  • Antipsychotic drugs

  • Social skills training, vocational rehabilitation, and psychologic and educational support

Schizophrenia cannot be cured, although hallucinations and delusions may be controlled with antipsychotic drugs, such as haloperidol, olanzapine, quetiapine, and risperidone. Children are particularly susceptible to the side effects of antipsychotic drugs. Side effects may include tremors, slowed movements, movement disorders, and metabolic syndrome (which includes obesity, type 2 diabetes, and abnormal levels of fat in the blood).

Social skills training, vocational rehabilitation, and psychologic and educational support for the child and counseling for family members are essential to help everyone cope with the disorder and its consequences. Doctors almost always refer children to psychiatrists who specialize in treating children.

Children may need to be hospitalized when symptoms worsen so that drug doses can be adjusted and children can be kept safe.

Resources In This Article

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • HALDOL
  • SEROQUEL
  • ZYPREXA
  • RISPERDAL