Diseases of the psyche were always difficult to treat and were a mystery even to scientists. Despite the many achievements of medicine, these pathologies are still referred to as complex ailments that cannot be fully investigated. Signs of mental illness can occur at any age. Often, they are diagnosed among children, adolescents and young people. One of the most common ailments encountered in psychiatric practice is schizophrenia.
Unfortunately, despite a long study of this pathology, it still cannot be explained. It is not uncommon for children to have schizophrenia. To control the disease at least partially, it is important to diagnose it in time and be observed by a psychiatrist throughout life.
Schizophrenia in children: a description of the pathology
Pediatric schizophrenia is considered a common mental pathology. On average, it affects about 1% of small patients. Such a high incidence rate is due to the fact that it is impossible to diagnose an ailment before the development of the clinical picture. Also, one cannot assume the occurrence of schizophrenia during fetal development, especially in the absence of a burdened history of this pathology. Some time ago, this diagnosis was made for almost any mental disorder a child has. Currently, there are clear criteria that characterize this disease. Children's schizophrenia refers to severe mental pathologies, characterized by a chronic and progressive course. Common symptoms of the disease are: a disorder of behavior and thinking, changes in the emotional background, hallucinatory syndrome, catatonia, crazy ideas, etc. The symptoms of childhood schizophrenia can be different. First of all, it depends on the form of pathology.
Causes of schizophrenia in children
A lot of research work was carried out, the purpose of which was to find out: why schizophrenia occurs. Children's type of disease is not very different from adult forms of the disease. However, it has a more unfavorable prognosis due to early development. Despite the efforts of scientists, it was not possible to identify the exact cause of the disease. However, psychiatrists point to a number of factors that increase the risk of schizophrenia in children. These include:
- Burdened heredity for this disease. In most cases, there were people in the family of patients who suffered from schizophrenia. The risk of pathology increases not only in the presence of the disease in the parents, but also among other family members. It was revealed that there is a special gene responsible for the development of schizophrenia.
- Adverse effects on the embryo during the laying of organs. Damaging factors include drugs, drugs, alcohol, ionizing radiation, chemicals. These effects are especially dangerous in the first trimester of pregnancy. Indeed, at this moment, the laying of the nervous system occurs.
- Late pregnancy. Conception of a child over the age of 35 increases the risk of developing mental pathologies in the fetus.
- Chronic infectious diseases in a pregnant woman.
- Stay under stressful conditions. It is worth remembering that nervous strain during the wearing of a child affects not only the condition of the pregnant woman, but also adversely affects the fetus.
Despite the fact that it is impossible to establish the exact cause, it is worth taking measures to eliminate all risk factors.
Pathogenesis of childhood schizophrenia
Given the fact that the etiological factor has not been established with accuracy, the mechanism for the development of schizophrenia is also unknown. There are hypotheses according to which the pathogenesis of this mental disorder can be partially explained. Schizophrenia in childhood has the following development mechanisms:
- Hypoxia of brain cells during the maturation of nerve tissue. This implies local oxygen deficiency. During diagnostic procedures in patients with schizophrenia, it was revealed that the cortical regions of the right hemisphere of the brain, the thalamus, amygdala, temporal gyrus and the prefrontal region underwent hypoxia.
- Genetic changes. Most scientists believe that in the pathogenesis of childhood schizophrenia, mutations found in the short arm of chromosome 6 play a role. In addition, there is information about other violations of the genetic code in patients. However, the data are not confirmed by large-scale studies.
- Change in the activity of neurotransmitters. This is mostly dopamine. It is believed that the transmission of impulses under the influence of this substance in patients with schizophrenia is accelerated. In addition, other changes were identified. For example, a decrease in the activity of glutamate receptors caused by medications (the Ketamine preparation) causes the development of signs of schizophrenia in healthy people.
It is believed that the pathogenesis of the disease is based on a combination of several factors. However, it has not yet been possible to establish a direct relationship between damage to neurons, a change in mediator activity, and genetic theory.
Forms of schizophrenia in children
Children's schizophrenia, like adult, can occur in various forms. The type of pathology is established on the basis of the clinical manifestations of the disease. Often, children develop the following forms of the disease:
- Hebephrenic schizophrenia. This clinical option is considered the most unfavorable. Its main manifestation is hebephrenic syndrome. It is characterized by senseless excitement, antics, negativity and ridiculous outbursts of fun. Children suffering from this form of schizophrenia are not amenable to education and training. The first signs of pathology appear in 10-14 years.
- Simple schizophrenia. This form can develop at any age. In some cases, the first manifestations are noted in school years. In this case, the diagnosis is established : "early childhood schizophrenia." A similar variant of pathology is characterized by the absence of productive symptoms (hallucinations, delirium). The characteristic manifestations of the disease are apathetic-abulic syndrome and disinhibition of reflexes (hypersexuality, bulimia).
- Catatonic schizophrenia. This form of the disease is considered malignant. It occurs in 1-3% of patients. The features of this variant of schizophrenia include: mutism, negativism, disinhibition of primitive reflexes, copying behavior (echopraxia). Characteristic signs are: unnatural posture of the patient, increased muscle tone, catatonic agitation and stupor.
Another form of pathology is paranoid schizophrenia. It is characterized by the development of delusions of persecution, overvalued ideas, mental automatism (Kandinsky-Clerambo syndrome). Often, such manifestations of the disease occur in adults (25-40 years old). However, the development of this form of pathology in children is not excluded.
Pediatric schizophrenia: symptoms and signs of the disease
Clinical manifestations of the disease can occur both at an early age and in adolescents. It is believed that up to 5 years, pathology is almost impossible to identify. However, in subsequent years it is impossible to immediately make a diagnosis: "childhood schizophrenia." Symptoms should be monitored for a long time. Only after this, if there are several signs of pathology, the diagnosis is established: "schizophrenia" with an indication of its form. Symptoms of the disease include:
- Apatico-abulic syndrome. It is expressed in the fading of interest in the usual activities (school, favorite activities, games), laziness, indifference to the opinion of parents.
- Hallucinatory syndrome. In addition to progressive isolation, the child can talk alone with himself, perform some actions that imply the presence of a company (playing with an imaginary friend, cursing, having fun, etc.).
- Hebephrenic syndrome.
- Catatonia. With this form of the disease, specific manifestations such as the uterine posture, the “symptom of an air cushion” are observed - when the roller is pulled out from under the neck and head, the patient’s position does not change. That is, he remains in the same position.
Signs of early schizophrenia may include: unmotivated crying of the child, crying out, mood changes, unwillingness to communicate, etc.
Features of pathology in adolescents
The signs of childhood schizophrenia in adolescence are slightly different. In addition to the listed symptoms, in patients there is a disinhibition of simple reflexes (increased appetite, sexual concern), delusions, pseudo-hallucinations may appear. Adolescents often become uncontrollable, refuse to communicate with their parents, commit asocial acts. Patients stop attending school, express complete indifference to the events, thinking disorder is noted.
How does autism manifest in childhood schizophrenia?
Autism was previously considered one of the criteria for childhood schizophrenia. Currently, this disorder is isolated as a separate disease. Autism is a violation in a child of the ability to social interaction. In addition, the pathology is characterized by a depletion or lack of emotional background and speech reactions to others. Infantile schizophrenia is often accompanied by signs of autism. However, it is not the only manifestation of pathology and is characterized by weak severity.
Diagnosis of schizophrenia in children
It is not always easy to make a diagnosis of schizophrenia, since this disease can combine many signs characteristic of other mental disorders. The wave-like course of pathology (change of exacerbations and remissions) is taken into account. The diagnosis is made on the basis of the clinical picture and special psychological tests. It is important to exclude harmful effects on the child's body (toxic poisons, drugs).
How to treat childhood schizophrenia?
Treatment of childhood schizophrenia is aimed at increasing the duration of remissions, stopping severe mental syndromes. Used drugs from the group of antipsychotics (medications "Eglonil", "Thioridazine") and nootropics. All patients are shown psychotherapy, as well as preventive hospitalization and observation at least 2 times a year. What to stop the hallucinatory syndrome prescribed drugs "Haloperidol" and "Triftazin."
Prognosis for schizophrenia in children
A favorable prognosis can be with a simple form of schizophrenia. Symptoms become subtle, the frequency of exacerbations is reduced. However, complete cure is rare. With catatonic and hebephrenic form, the prognosis is poor. Children suffering from these pathology options need constant care, they are assigned 1 group of disability.
How to behave with a child with schizophrenia
Communicating with a child suffering from schizophrenia is quite difficult, especially during an exacerbation of pathology. Despite the desire to help, it is worth remembering that you can provoke inappropriate behavior, aggression, or vice versa - even greater isolation. Therefore, it is advisable not to reproach the child, and also not to indicate to him that he is sick. Such children should be treated in the same way as healthy people, so that they do not feel alienated. During an exacerbation, it is recommended that the child be hospitalized in a hospital.
Prevention of schizophrenia in children
It is impossible to prevent childhood schizophrenia, but you should do everything so that the child is born healthy. For this, stressful situations and adverse environmental influences must be avoided. In the presence of pathology in relatives, it is necessary to be examined by a psychologist and genetics for both spouses before conceiving a child.