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Childhood Schizophrenia

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

Childhood 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. It typically begins anytime from mid-adolescence to a person's mid-30s, most often during a person's mid-20s (see Schizophrenia and Delusional Disorder). Schizophrenia very rarely develops before adolescence.

Schizophrenia probably occurs because of chemical abnormalities in the brain and problems during the brain’s development, which occur during pregnancy and early childhood 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.


Like adults with schizophrenia, children 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 adolescents, use of illicit drugs may cause symptoms similar to those of schizophrenia. They may withdraw, start having unusual emotions, and/or have hallucinations, delusions, and paranoia.


  • 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 disorders (such as drug abuse or a brain infection, injury, or tumor) that can cause similar symptoms.

Did You Know...

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


  • 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 (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 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.

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