Childhood schizophrenia

Childhood schizophrenia
Other namesChildhood type schizophrenia; schizophrenia, childhood type; childhood-onset schizophrenia (COS); very early-onset schizophrenia (VEOS); schizophrenic syndrome of childhood
SpecialtyChild psychiatry (EU), Child and adolescent psychiatry (USA), clinical psychology
SymptomsHallucinations, delusions, disorganized behavior or catatonia, negative symptoms (i.e., avolition or reduced affect display)[1]
Usual onsetBefore the age of 13 years
TypesEpisodic-progredient/shiftlike childhood schizophrenia (malignant, paranoid and slow-progressive sub-types), continuous childhood schizophrenia, recurrent childhood schizophrenia (the rarest form – 5 % of all cases)[2]
Differential diagnosisMajor 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
MedicationAntipsychotics
Frequency1⁄5 of all forms of psychosis of the schizophrenia spectrum;[2] 1.66:1000 among children (0–14 years)[2]

Childhood schizophrenia (also known as childhood-onset schizophrenia, and very early-onset schizophrenia) is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose.[3] Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments.[1][4][5] Differential diagnosis is 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.[4][6]

The disorder presents symptoms such as 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 schizophrenia, which features more systematized delusions.[7] Among the psychotic symptoms seen in childhood schizophrenia, non-verbal auditory hallucinations are the most common, and include noises such as shots, knocks, and bangs.[citation needed] Other symptoms can include irritability, searching for imaginary objects, low performance, and a higher rate of tactile hallucinations compared to adult schizophrenia. It typically presents after the age of seven.[8] About 50% of young children diagnosed with schizophrenia experience severe neuropsychiatric symptoms.[9] Studies have demonstrated that diagnostic criteria are similar to those of adult schizophrenia.[10][11] Neither DSM-5 nor ICD-11 list "childhood schizophrenia" as a separate diagnosis. The diagnosis is based on thorough history and exam 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.

  1. ^ a b Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). American Psychiatric Association. 2013. pp. 99–104. ISBN 9780890425541.
  2. ^ a b c Tiganov AS, Snezhnevsky AV, Orlovskaya DD (1999). "Шизофрения в детском и подростковом возрасте" [Schizophrenia in childhood and adolescence]. In Tiganov AS (ed.). Руководство по психиатрии в 2 томах [Textbook of Psychiatry in 2 volumes] (in Russian). Vol. 1. Moscow: "Медицина" = ["Medicine"]. pp. 472–488. ISBN 5-225-02676-1. // Research of childhood schizophrenia types by The Mental Health Research Center (MHRC) (Russia)
  3. ^ Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). American Psychiatric Association. 2013. pp. 102–103. ISBN 9780890425541.
  4. ^ a b Kendhari J, Shankar R, Young-Walker L (July 2016). "A Review of Childhood-Onset Schizophrenia". Focus. 14 (3): 328–332. doi:10.1176/appi.focus.20160007. PMC 6526799. PMID 31975813.
  5. ^ Ritsner MS, ed. (2011). Handbook of Schizophrenia Spectrum Disorders, Vol. II. Dordrecht, Heidelberg, London, New York: Springer Science+Business Media. pp. 195–205. doi:10.1007/978-94-007-0831-0. ISBN 978-94-007-0830-3.
  6. ^ Stayer, CATHERINE; Sporn, ALEXANDRA; Gogtay, NITIN; Tossell, JULIA; Lenane, MARGE; Gochman, PETER; Rapoport, JUDITH L (2004-08-01). "Looking for Childhood Schizophrenia: Case Series of False Positives". Journal of the American Academy of Child & Adolescent Psychiatry. 43 (8): 1026–1029. doi:10.1097/01.chi.0000127573.34038.e4. ISSN 0890-8567. PMID 15266198.
  7. ^ Bettes BA, Walker E (July 1987). "Positive and negative symptoms in psychotic and other psychiatrically disturbed children". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 28 (4). Wiley-Blackwell: 555–68. doi:10.1111/j.1469-7610.1987.tb00223.x. PMID 3654807.
  8. ^ Baribeau DA, Anagnostou E (December 2013). "A comparison of neuroimaging findings in childhood onset schizophrenia and autism spectrum disorder: a review of the literature". Frontiers in Psychiatry. 4: 175. doi:10.3389/fpsyt.2013.00175. PMC 3869044. PMID 24391605.
  9. ^ Lambert LT (April–June 2001). "Identification and management of schizophrenia in childhood". Journal of Child and Adolescent Psychiatric Nursing. 14 (2): 73–80. doi:10.1111/j.1744-6171.2001.tb00295.x. PMID 11883626.
  10. ^ Nicolson R, Rapoport JL (November 1999). "Childhood-onset schizophrenia: rare but worth studying". Biological Psychiatry. 46 (10). Elsevier BV: 1418–28. doi:10.1016/s0006-3223(99)00231-0. PMID 10578456. S2CID 45154449.
  11. ^ Spencer EK, Campbell M (1994). "Children with schizophrenia: diagnosis, phenomenology, and pharmacotherapy". Schizophrenia Bulletin. 20 (4): 713–25. doi:10.1093/schbul/20.4.713. PMID 7701278.