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Schizophrenia in Children, Teens and Young Adults

Schizophrenia is a chronic mental health disorder that affects how a person feels, thinks, and behaves. The condition causes people to shift back and forth between reality and their distorted perceptions of reality. Early treatment is crucial to help kids and teens with schizophrenia do their best in school or work and in their relationships with others.

At what age does schizophrenia usually develop?

Schizophrenia is usually diagnosed anywhere between the late teen years and the early 30s. When teens are diagnosed before they’re 18, it’s called early-onset schizophrenia. Kids younger than 13 can develop schizophrenia too, known as childhood-onset schizophrenia, but this is extremely rare.

Schizophrenia tends to show up earlier in males than females. For males, it’s typically between ages 18 and 25 and for females, between ages 25 and 35.

Signs and symptoms of schizophrenia

Early Signs

When schizophrenia first starts, you may notice issues such as:

Thinking

  • Confused thoughts and speech

  • Difficulty concentrating

  • Strange ideas, thoughts, or statements

  • Not being able to tell the difference between reality and television or dreams

Emotions

  • Excessive moodiness

  • Severe depression or irritability

  • Suicidal thoughts

  • Lack of emotion

  • Paralyzing anxiety and fear

  • Extreme suspicion of others

Behavior

  • Having new problems at school

  • Withdrawing from family and friends

  • Increased isolation

  • Immature behavior

  • Noticeable changes in personality or behavior

  • Problems with friends or peers

  • Not keeping up with personal hygiene

Later Signs

As kids and teens with schizophrenia get older, their signs and symptoms become more like the ones adults experience. These may include:

Psychotic Symptoms

When schizophrenia cases a shift to altered reality, this is called psychosis. Periods of psychosis are also known as psychotic episodes. During a psychotic episode, a person may not be able to tell what’s real and what’s not. They may hear or see things that aren’t real (hallucinations). They might have beliefs or fears that aren’t true (delusions). Their thoughts may be disorganized, their speech may not make sense, and they may behave oddly. Kids and teens are more likely to have visual hallucinations and less likely to have delusions than adults.

Negative symptoms

  • Negative symptoms mean your child isn’t functioning normally. Examples include:

  • Lack of motivation

  • An obvious decline in personal hygiene

  • Avoiding people and activities

  • Loss of enjoyment

  • No eye contact, no change in facial expressions, or talking in a flat tone

Behavior changes

  • You may notice differences in your child’s behavior, such as:

  • Unpredictable behavior

  • Difficulty completing tasks or meeting goals

  • Unresponsive to others

  • Moving around too much

  • Unusual posture

Cognitive symptoms

Some people experience serious cognitive (thinking) symptoms, while others don’t notice them as much. These symptoms can include:

  • Problems with concentration

  • Attention and memory problems

  • Difficulty processing and using information

What causes schizophrenia?

No one knows what causes schizophrenia. Experts believe that it develops from a combination of factors, including genetics, environment, and brain chemistry.

How is schizophrenia diagnosed?

Your pediatrician may be the first healthcare provider you see if you’re concerned that your child has schizophrenia. They can rule out other causes of your child’s symptoms like another mental illness, a medical condition, or drug or alcohol use.

Be aware that diagnosing schizophrenia can be a long process, especially with kids and teens. It’s important that your doctor makes absolutely sure there isn’t something else going on before making a diagnosis of schizophrenia.

How is schizophrenia treated?

If your child is diagnosed with schizophrenia, they’ll need treatment for the rest of their life. A child psychiatrist with experience in treating kids with schizophrenia will likely be in charge of your child’s care. There will probably be other team members too, such as nurses and therapists.

Treatments for schizophrenia include:

Medications

Antipsychotic medications are the foundation of treatment for kids and teens with schizophrenia. These medicines are the same kinds that are used for adults with schizophrenia. They help with psychotic symptoms like hallucinations and delusions.

Like all medications, the goal is to keep your child’s symptoms to a minimum using the lowest possible dose of medicine. It can take some time for your doctor to figure out which medication (or combination of medications) works best and at what dose. Your child may need other medicines as well, such as anti-anxiety medication or antidepressants.

Antipsychotics have potential side effects and health risks. The side effects in children and teens can be different and more serious than they are in adults. Your doctor will monitor for side effects with certain medications. Keep track of any side effects you notice and let your doctor know if they are serious or don’t go away.

Cognitive behavioral therapy (CBT)

Psychotherapy, also known as talk therapy, is another instrumental part of your child’s treatment. One type that’s good for treating schizophrenia is cognitive behavioral therapy (CBT). It can help your child cope with hallucinations and delusions, as well as work on behaviors. It also helps them learn to manage the challenges and stress that schizophrenia can create.

Other psychosocial treatments

There are other treatments that can improve your child’s life too. For instance, family therapy can boost your family’s communication and help you learn more about what your child is dealing with.

Social skills training can help your child build relationship skills and improve their memory and attention problems.

Your child may also benefit from special education services at school. This can be in the form of a 504 or an individualized education program (IEP). A federal program called Supported Employment can help your child get and keep a job.

Hospitalization

There may be times when your child needs to be hospitalized to prevent danger to themselves or others. This can happen when their symptoms are severe and they need extra care and a safe place. Once your child’s symptoms are under better control, they can go home. You can also look into partial hospitalization or residential treatment programs.

Remember

Early intervention can greatly improve symptoms for a child or teen with schizophrenia. Left untreated, schizophrenia can cause serious behavioral, emotional, and health problems. If you think your child has signs or symptoms of schizophrenia, be sure to talk to your pediatrician.​



Last Updated
7/28/2021
Source
American Academy of Pediatrics Committee on Adolescence (Copyright © 2021)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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