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Schizophrenia in Children and Adolescents

By

Josephine Elia

, MD, Nemours/A.I. duPont Hospital for Children

Reviewed/Revised May 2023
VIEW PROFESSIONAL VERSION

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 medications 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. (See also Schizophrenia Schizophrenia Schizophrenia is a mental disorder characterized by loss of contact with reality (psychosis), hallucinations (usually, hearing voices), firmly held false beliefs (delusions), abnormal thinking... read more in adults.)

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.

Recent research also indicates that there is an increased risk of developing certain psychotic disorders (namely, bipolar disorder Bipolar Disorder In bipolar disorder (formerly called manic-depressive illness), episodes of depression alternate with episodes of mania or a less severe form of mania called hypomania. Mania is characterized... read more and schizophrenia) among young adolescents who use cannabis products. This increased risk is not explained by genetic factors. There is concern that the recent legalization of marijuana may give adolescents (and their parents) a false sense of security about using this drug.

Symptoms

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

  • A visit with a doctor or behavioral health specialist

  • 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 medications

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

Schizophrenia cannot be cured, although hallucinations and delusions may be controlled with antipsychotic medications Antipsychotic drugs Schizophrenia is a mental disorder characterized by loss of contact with reality (psychosis), hallucinations (usually, hearing voices), firmly held false beliefs (delusions), abnormal thinking... read more , such as haloperidol, olanzapine, quetiapine, and risperidone. Children are particularly susceptible to the side effects of antipsychotics. Side effects may include tremors, slowed movements, movement disorders, and metabolic syndrome Metabolic Syndrome Metabolic syndrome is characterized by a large waist circumference (due to excess abdominal fat), high blood pressure, resistance to the effects of insulin (insulin resistance) or diabetes,... read more (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 medication doses can be adjusted and children can be kept safe.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Haldol, Haldol Decanoate
Zyprexa, Zyprexa Intramuscular, Zyprexa Relprevv, Zyprexa Zydis
Seroquel, Seroquel XR
PERSERIS, Risperdal, Risperdal Consta, Risperdal M-Tab, UZEDY
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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