Childhood schizophrenia
| Childhood schizophrenia | |
|---|---|
| Other names | Childhood-type schizophrenia; schizophrenia, childhood type; childhood-onset schizophrenia (COS); very early-onset schizophrenia (VEOS); schizophrenic syndrome of childhood |
| Specialty | Child psychiatry (European Union), child and adolescent psychiatry (United States), clinical psychology |
| Symptoms | Hallucinations, delusions, disorganized behavior, catatonia, negative symptoms (i.e., avolition or reduced affect display) |
| Usual onset | Before the age of 13 years |
| Types | Episodic-progredient/shiftlike childhood schizophrenia (malignant, paranoid, and slow-progressive subtypes), continuous childhood schizophrenia, recurrent childhood schizophrenia (the rarest form—5 % of all cases) |
| Differential diagnosis | Major depressive disorder or bipolar disorder with psychotic or catatonic features, brief psychotic disorder, delusional disorder, obsessive–compulsive disorder and body dysmorphic disorder, autism spectrum disorder or communication disorders, other mental disorders associated with a psychotic episode |
| Medication | Antipsychotics |
| Frequency | 1⁄5 of all forms of psychosis of the schizophrenia spectrum; 1.66 per 1000 children (0–14 years) |
Childhood schizophrenia (also known as childhood-onset schizophrenia and very early-onset schizophrenia) is similar in characteristics to schizophrenia that develops at a later age, with the major difference being an onset before the age of 13 years and a more challenging diagnosis. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect, avolition, and apathy, and a number of cognitive impairments. Differential diagnosis is often problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention-deficit/hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.
The disorder is associated with symptoms like auditory and visual hallucinations, delusional thoughts or feelings, and abnormal behavior, profoundly impacting the child's ability to function and sustain normal interpersonal relationships. Delusions are often vague and less developed than those of adult-onset schizophrenia, which features more systematized delusions. Among the psychotic symptoms seen in childhood schizophrenia, non-verbal auditory hallucinations are the most common and often sound like shots, knocks, and bangs. Other symptoms can include irritability, searching for imaginary objects, low performance, and a higher rate of tactile hallucinations compared to adult-onset schizophrenia. It typically presents after the age of seven. About 50% of young children diagnosed with schizophrenia experience severe neuropsychiatric symptoms. Studies have demonstrated that diagnostic criteria are similar to those of adult-onset schizophrenia. Neither DSM-5 nor ICD-11 list "childhood schizophrenia" as a separate diagnosis. The diagnosis is based on a thorough history and psychiatric examination by a child psychiatrist, exclusion of medical causes of psychosis (often by extensive testing), observations by caregivers and schools, and, in some cases (depending on age), self-reports from pediatric patients.