Childhood schizophrenia is a chronic disorder involving abnormal thought, perception, and social behavior.

• 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. It typically develops during late adolescence and early adulthood (see Schizophrenia and Delusional Disorder). When schizophrenia does develop during childhood, it usually begins between the age of 7 and the start of adolescence.

Schizophrenia probably occurs because of chemical abnormalities in the brain and problems during the brain's development. Doctors do not know 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

Children with schizophrenia typically become withdrawn and lose interest in activities. Thinking and perception are distorted. These symptoms may continue for some time before worsening. As with adults, children with schizophrenia are likely to have hallucinations, delusions, and paranoia, often fearing that others are planning to harm them or are controlling their thoughts. Their emotions are sometimes blunted. That is, their voice and facial expressions do not change in response to emotional situations. Events that normally make people laugh or cry may produce no response.

In adolescents, use of illicit drugs may cause symptoms similar to those of schizophrenia.

Diagnosis

There is no specific diagnostic test for schizophrenia. Doctors base the diagnosis on a thorough evaluation of symptoms over time and psychologic tests. They also do tests to check for other disorders (such as drug abuse or a brain tumor) that can cause similar symptoms.

Did You Know... Schizophrenia should not be blamed on poor parenting or difficulties during childhood.

Treatment

Schizophrenia cannot be cured, although hallucinations and delusions may be controlled with antipsychotic drugs, such as haloperidolSome Trade Names
HALDOL
, olanzapineSome Trade Names
ZYPREXA
, quetiapineSome Trade Names
SEROQUEL
, and risperidoneSome Trade Names
RISPERDAL
(see Schizophrenia and Delusional Disorder). 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—see Obesity and the Metabolic Syndrome: Metabolic Syndrome).

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 they can be kept safe.

Last full review/revision February 2009 by Hugh F. Johnston, MD