FFFSchizophrenia In Children

No. 49; Reviewed October 2018

Schizophrenia is a serious psychiatric illness that causes changes in thinking, feelings, and unusual or strange behavior. It is uncommon in children and hard to recognize in its early phases. Symptoms that are more prominent may be noted in adolescents and young adults. The cause of schizophrenia is not known. Current research suggests a combination of brain changes, biochemical causes, genetic and environmental factors. Early diagnosis and medical treatment are important. Schizophrenia is a life-long disease that can be controlled but not cured.

The symptoms and behavior of children and adolescents with schizophrenia may be different from those of adults with this illness. The following symptoms and behaviors can occur in children or adolescents with schizophrenia:

  • seeing things and hearing voices which are not real (hallucinations)
  • odd and eccentric behavior and/or speech
  • unusual or bizarre thoughts and ideas
  • confusing television and dreams from reality
  • confused thinking
  • new academic problems
  • extreme moodiness
  • personality changes
  • ideas that people are out to get them or talking about them (paranoia)
  • severe anxiety and fearfulness
  • difficulty relating to peers and/or keeping friends
  • withdrawal and increased isolation
  • worsening personal grooming

The behavior of children with schizophrenia may change slowly over time. For example, children who used to enjoy relationships with others may start to become more shy or withdrawn and seem to be in their own world. Sometimes youngsters will begin talking about strange fears and ideas. They may start to say things that do not make sense. These early symptoms and problems may first be noticed by the child's teachers. Children with these symptoms must have a complete evaluation. Parents should ask their family physician or pediatrician to refer them to a child and adolescent psychiatrist, who is specifically trained and skilled at evaluating, diagnosing, and treating children with schizophrenia. Treating children with schizophrenia can involve a combination of medication, individual therapy, and family therapy, and specialized programs (school, activities, etc.) are often necessary. Psychiatric medication can be helpful for many of the symptoms of the illness. These medications require careful monitoring by a psychiatrist (preferably a child and adolescent psychiatrist).

An experienced child and adolescent psychiatrist should be able to differentiate changes in thinking, feelings, and unusual behavior that could be due to a person’s or their families’ cultural belief system versus changes caused by a mental illness. Families should feel comfortable discussing these beliefs with their mental health providers; for example, some cultures believe they can communicate with deceased individuals, and so on. Please let your doctor know if these or other beliefs are part of your family’s belief and cultural structure.