Schizophrenia in children

Schizophrenia is an uncommon psychiatric illness in children, affecting only about 1 in 40,000, compared to 1 in 100 in adults. The illness is hard to recognise in its early phases. The behaviour of children and teens with schizophrenia may differ from that of adults with this illness.

Causes of schizophrenia in children

Damage to the nervous system during development seems to be of greater importance in childhood schizophrenia than in the adult-onset type. It is likely that genetic predisposition also plays a part. The risk of schizophrenia rises from 1% for individuals with no family history of the illness to 10% for people with a first degree relative with it, to 50% if an identical twin has it.

Prenatal insults including viral infections, such as maternal influenza during the second trimester, starvation, lack of oxygen at birth, and untreated blood incompatibility may also contribute to the development of schizophrenia in childhood. Children, unlike individuals with adult-onset schizophrenia show evidence of progressively abnormal brain development.

For more general information about this condition, see the Schizophrenia section.

Children who used to enjoy relationships with others may become more shy or withdrawn and seem to be in their own world.

Symptoms of childhood schizophrenia

Most children with schizophrenia show delays in language and other functions long before their psychotic symptoms (hallucinations, delusions, and disordered thinking) appear, usually at age seven or later. In the first years of life, about 30% of these children have temporary symptoms of developmental disorder, such as rocking, posturing and arm flapping.

Early warning signs
  • Trouble discerning dreams from reality
  • seeing things and hearing voices that are not real,
  • confused thinking
  • vivid and bizarre thoughts and ideas
  • extreme moodiness
  • peculiar behaviour
  • concept that people are "out to get them"
  • behaving younger than they are
  • severe anxiety and fearfulness
  • confusing television or movies with reality
  • severe problems in making and keeping friends
The behaviour of children with this illness may change over time. The schizophrenic psychosis (hallucinations, delusions and sense of unreality) develops gradually in children, without the sudden psychotic break that sometimes occurs in adolescents and adults.

Children may begin talking about strange fears and ideas. They may start to cling to parents or say things that do not make sense. Children who used to enjoy relationships with others may become more shy or withdrawn and seem to be in their own world. Children with schizophrenia experience difficulty in managing everyday life. In common with their adult counterparts, children with schizophrenia are at an increased risk of suicide.

Misdiagnosis of schizophrenia in children

Misdiagnosis of schizophrenia in children is all too common. Schizophrenia is often confused with autism but is distinguished from it by the persistence of hallucinations and delusions for at least 6 months, and a later age of onset, 7 years or older. Autism is usually diagnosed by age 3.

Schizophrenia is also different to a brief psychosis which can be seen in people with depression, personality and dissociative disorders in children. Adolescents with bipolar disorder sometimes have acute onset of manic episodes that may be mistaken for schizophrenia. Children who have been victims of abuse may sometimes claim to hear voices of / see visions of the abuser.