Schizophrenia is a fairly common disease. It is diagnosed not only in adults, but also in children. What is the essence of this ailment? The answer to this question is not known to many parents. Only specialists have an idea of the nature of the disease. So, schizophrenia in a child, symptoms, diagnosis and treatment of the disease are topics that should be addressed.
Schizophrenia: a breakdown of the term and prevalence of the disease
The above term refers to a brain disorder. With it, signs of schizophrenia appear : human behavior and mental functions are impaired. Previously, this ailment was called mental illness, madness, madness. In 1896, E. Kraepelin began to apply the concept of “early dementia” to the disease. Only in 1911 did the term “schizophrenia” come to be used thanks to E. Bleiler.
According to statistics, at least 1% of the inhabitants of our planet suffer from schizophrenia. About 10% of this number are children. They can have a disease at different ages. For this reason, experts divide the disease into groups:
- schizophrenia of early and preschool age;
- schizophrenia of school age;
- schizophrenia in adolescence.
Causes of schizophrenia in children
The views of modern specialists on the causes of the onset of the disease are based on a predisposition and stress model. In accordance with it, the interaction of predispositions with protective and stress factors in the development process plays a huge role. The predisposition includes:
- the transfer of genes, due to which the child may develop a disease;
- pathological processes occurring in the central nervous system;
- lack of conditions necessary for training.
Stress factors are events that increase the likelihood of developing a disease such as schizophrenia in a child. Symptoms often appear due to the death of a relative. Negative factors also include sources of chronic stress. An example is child abuse. It is worth noting that with a genetic predisposition, schizophrenia does not always develop. The disease appears when the stress factors are sufficiently strong and provided that the person does not have sufficient resources to resist the disease.
Features of schizophrenia of early and preschool age
Statistics show that in about 69% of children of early and preschool age, the disease begins before the age of 3 years. Schizophrenia in a child of 2 years may well appear. In 26% of babies, the disease develops between 3 and 5 years. In other children, the disease is diagnosed at 5-8 years. Most often, schizophrenia is detected in boys. Girls are less likely to experience this disorder.
Schizophrenia of early and preschool age is divided into several forms:
- malignant current;
- continuously progressive;
- sluggish.
Malignant current form in early and preschool age
At 1.5-2 years, such a schizophrenia in a child begins to develop. Symptoms include the extinction of mental activity, a decrease in interest in games, the disappearance of emotional attachment, and a desire for communication. The patient ceases to entertain himself with toys. His games consist of a uniform waving, tapping with non-game objects (pieces of iron, sticks, ropes).
Somewhere in a year, the malignancy of the course becomes more noticeable. Children stop answering questions, do not respond to separation. Their games are becoming even more meager. In children, visual perception is impaired, fears appear. After a couple of years, the condition of sick children may improve slightly. The severity of all observed suspicious symptoms decreases, excitement and fears disappear, sleep improves. Exacerbation of schizophrenia usually occurs with a second age crisis, at 7-8 years.
Continuously-progressive form at early and preschool age
This form of schizophrenia is characterized by the onset of symptoms of the disease at the age of 5-9 years. Children appear suspicious and distrustful. They can refuse friendship with other kids, arguing that they will take away all the toys. In some cases, delusional attitude towards parents appears.
With a continuously-progressive form, children can involuntarily fantasize. With the disease, visual and auditory hallucinations appear. They are joined by the experiences that arise in a dream.
Sluggish form of schizophrenia at an early and preschool age
How to recognize schizophrenia in a child that occurs in this form? The disease begins during a 3-4 year crisis. Its occurrence is provoked by such psychogenic factors as parting with mom and dad, and a change in situation. The illness in a child develops slowly. The circle of communication is gradually decreasing. The child only contacts specific children. This is due to a reduced need for communication.
The following manifestations are still characteristic of the sluggish form of schizophrenia:
- decreased appetite;
- violation of the pace of speech;
- sleep disorders
- unmotivated fears associated with fairy tales, fantasies, which subsequently often provoke the emergence of ideas of persecution.
With parents, the child breaks up easily. Some children do not let their mothers and fathers go, but such behavior is observed only because of experienced fears. In some cases, children manifest such signs as cruelty, viciousness, aggression, sadism.
Features of schizophrenia in school children
The psychological picture of schizophrenia in schoolchildren consists in the fact that the disease occurs imperceptibly and proceeds slowly. Some patients have various fears. Children worry about their own lives and the health of their parents. At first, the experiences can be justified. Then they lose their meaning and are not associated with any events. Children lose interest in learning, playing games, crazy ideas about the influence of otherworldly forces appear.
In other children, the disease is different. They invent their own fantasy world, which they depict in drawings. Patients are completely immersed in their fantasies, whisper something, grimace, hardly switch to real events. Such children play alone, require others to be called fictitious names.
Features of schizophrenia in adolescence
In some cases, precursors occur before the onset of the disease. They are ridiculous behavior, inexplicable acts, depressive or manic attacks. A similar condition in children lasts from several days to several weeks.
After the forerunners, schizophrenia in teenagers is provoked by serious conflicts with peers, scandals with parents, and attempts at violence. The emerging disease proceeds in different ways. In some, activity decreases, interests disappear, and emotional-volitional disorders increase. Others have obsessive fears, thoughts, drives.
Diagnosis of the disease according to the criteria of ICD-10
For a schizophrenia disease, a test that could be carried out in a laboratory and that would indicate a disease has not been developed. The diagnosis is made by doctors taking into account the criteria of the ICD-10 (International Classification of Diseases 10 revision). According to them, at least 2 symptoms (from the last 5 signs listed below) or 1 clear symptom (from the first 4 signs) should be inherent in the disease:
- silent repetition of thoughts in the head;
- delusional perception;
- auditory hallucinations, the appearance in the head of other people's voices that discuss or comment on the patient's behavior;
- crazy ideas;
- constant hallucinations of any sphere, accompanied by unstable or incompletely formed delusions without a clear emotional content, or constant overvalued ideas ;
- torn speech that does not have a single meaning;
- the presence of such disorders as hardening, agitation, lack of answers to asked questions, stupor, negativism;
- behavior change, loss of interest in the world around us and communication with other people, isolation;
- the presence of negative symptoms such as apathy, inadequacy or poverty of emotions, social exclusion and social unproductive.
Differential diagnosis
Schizophrenia in adolescents and young children is manifested by such signs that are inherent in many other diseases, therefore, differential diagnosis is necessary . The tasks of specialists include the exclusion of the presence of somatic, neurological and organic mental disorders, toxic substances in the body.
If a child has schizophrenia, what should parents do? They need to contact a specialist in order to obtain a referral for a full medical examination, including:
- inspection;
- general and biochemical blood tests;
- Analysis of urine;
- ECG;
- screening for drugs and other studies (if necessary).
Treatment principles
The diagnosis of schizophrenia necessitates the use of a classical treatment regimen. It includes the following steps:
- stopping therapy;
- stabilizing (aftercare) therapy;
- maintenance therapy.
The purpose of stopping therapy is to eliminate the symptoms of the disease (delirium, hallucinations, psychomotor disorders). The treatment uses antipsychotics - psychotropic drugs. With stabilizing therapy, a drug is prescribed, which was used in the first stage and had a positive effect. A neuroleptic is used in a lower dose until the symptoms are completely eliminated. Supportive treatment is carried out with the same drugs that eliminated the manifestations of the disease, but in much lower dosages to prevent recurrence.
The harm of therapy and the need to use psychosocial treatments
A diagnosis of schizophrenia is a chronic disorder. Long-term prognoses for most patients are pessimistic. However, thanks to antipsychotic drugs, it is possible to achieve an improvement in the condition of patients. In the treatment of schizophrenia in children, antipsychotics are widely used. Moreover, the effect of drugs on the children's body is not yet fully understood. Medication sometimes causes serious side effects. Thus, treatment is far from a safe process, but it cannot be abandoned.
Harm from psychotropic drugs is one of the features of the treatment of the disease. The second feature is the need for psychosocial treatment methods. They include social skills training, family intervention, placement of patients in special schools.
In conclusion, it is worth noting that schizophrenia in a child whose symptoms are diverse is usually a hereditary ailment. However, studies show that not in all cases at birth of monozygotic twins, both children develop schizophrenia. This confirms that the probability of its occurrence is affected not only by genetic factors. If symptoms of schizophrenia appear, consult a doctor. The disease requires diagnosis (for the disease "schizophrenia", a special test is not performed in the laboratory, the clinical picture is taken into account, complaints, blood and urine tests are taken, additional studies are prescribed). The disease also needs long-term treatment and the use of anti-relapse drugs after eliminating the existing symptoms.