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From loss to breakthrough! How to identify the early signs of schizophrenia in children?
Childhood schizophrenia (also called child-onset schizophrenia) is a mental illness with similar features to adult schizophrenia, but with onset before the age of 13, which makes it more difficult to diagnose. The disorder is characterized by positive symptoms (such as hallucinations, delusions, and disorganized speech), negative symptoms (such as blunted affect, lack of motivation, and apathy), and a range of cognitive deficits. Schizophrenia in children is often a diagnostic challenge because many other neurodevelopmental disorders, such as autism spectrum disorder, language disorders, and attention deficit hyperactivity disorder, have similar signs and symptoms to those of childhood schizophrenia.
"Symptoms of schizophrenia in children may appear after the age of seven and can have a profound impact on a child's life."
According to research, approximately 50% of young children diagnosed with schizophrenia will experience severe neuropsychiatric symptoms. Although DSM-5 and ICD-11 do not list "childhood schizophrenia" as a separate diagnosis, through a detailed medical history and examination, and by excluding other possible medical causes of delusions, including observation of caregivers and schools, There are also cases where self-reporting from younger patients can lead to a diagnosis. This process is particularly difficult because a child's hallucinations are sometimes difficult to distinguish from normal childhood play or imagination.
Signs and symptoms
Symptoms of schizophrenia in children are similar to those in adults. Early diagnostic signs may include delays in language and motor development. Some children may exhibit arm flailing or body rocking behaviors and appear anxious, confused, or fussy in their daily lives. Children who are experiencing hallucinations may have difficulty describing their feelings clearly, which makes diagnosing this mental illness particularly difficult in the initial stages. 20% of children with schizophrenia may show borderline or full-blown intellectual disability, while negative symptoms include apathy, lack of motivation, disinterest in activities, and lack of social skills.
“For children who display emotional indifference, it is impossible to tell their emotions from their facial expressions and tone of voice.”
Pathogenesis
The development of schizophrenia may be affected by a variety of environmental factors, such as perinatal complications and maternal infections during pregnancy. Studies have shown that German measles or influenza infection during pregnancy is associated with schizophrenia in children. These factors may contribute to the early onset of symptoms by affecting brain structure and cognitive function. Genetic susceptibility is also an important factor. Individuals with a family history of mental illness, especially first-degree relatives, are more likely to develop the disease.
Diagnostic Procedures
According to the DSM-5 diagnostic manual released by the American Psychiatric Association in 2013, in order to be diagnosed with schizophrenia, a patient must exhibit two major symptoms within a month and have a significant impact on social or occupational functioning. This includes symptoms such as delusions, hallucinations, or disorganized speech. In children, the diagnosis process usually relies on reports from parents, teachers, or other close people, and a wide range of tests to rule out other potential causes.
Treatment methods
Research suggests that identifying signs and intervening early may improve treatment outcomes, especially for children with a family history of related mental illnesses. Although current treatments for childhood schizophrenia are still under development, current interventions include medications and psychosocial support aimed at helping patients and their families manage symptoms and improve quality of life.
“Knowing early signs and providing timely intervention is critical to improving treatment outcomes.”
Knowing the early signs of schizophrenia in children is crucial for both treatment and prevention. For parents and educators, keenly observing and understanding children's behavioral changes and seeking professional help can change the future development of children to some extent. Can you recognize these signs in the children around you so they don’t struggle with being lost?
