What Is Childhood Schizophrenia?

Schizophrenia can occur in adults and children, and is a more common type of mental illness in children. The prevalence of schizophrenia in children is lower than in adults. According to foreign reports, the prevalence of schizophrenia under the age of 15 is 0.14% to 0.34%. Domestic literature reports that the prevalence of schizophrenia in children is 0.05% to 0.08%, and the male-female ratio is similar. Onset is less before the age of 10; significantly increased after the age of 10. The youngest age is 3 years old, and the majority are 12 to 14 years old.

Basic Information

English name: childhood schizophrenia
Visiting department: Department of Psychology
Multiple groups: 12 to 14 years old

Common causes: Family with a genetic history of psychosis, perinatal damage, severe trauma, etc.
Common symptoms: Emotions, behavior changes, sleep disorders, inattention, learning difficulties, etc.

Causes of childhood schizophrenia

Genetic factor

The incidence of a genetic history of psychosis is higher in families of children with this disorder (16% to 64%).

2. Organic factors

It is more common for children with this disease to have a history of perinatal damage. Delayed maturation of the nervous system, software signs and EEG abnormalities are common in recent neurological examinations. In recent years, studies have shown that the evoked potential P300 latency and wave amplitude are significantly reduced in children with schizophrenia; CT scans of the skull, magnetic resonance imaging ) And other research results suggest that frontal lobe, basal ganglia, and temporal lobe damage are closely related to schizophrenia.

3. Psychosocial factors

Children with severe trauma, such as divorced parents, death of their loved ones, failure to go to school, and other life events that cause schizophrenia are more common, and psychosocial factors also have an important impact on the duration and prognosis of the disease.

4. Pre-illness Personality

The pre-illnesses of children with this disease are mostly introverted. Based on their personality differences or imperfections, they are affected by environmental factors and increase the risk of disease.

5. Biochemical factors

It is generally believed that this disease is related to excessive central dopaminergic system activity and insufficient noradrenergic function. Some studies have found that plasma levels of dopamine beta-hydroxylase are elevated in children with this disease, and the cholinergic system is inhibited.

Clinical manifestations of schizophrenia in children

Onset form

More slowly onset, with increasing age, acute onset gradually increased.

2. Early symptoms

Early symptoms of childhood schizophrenia are mainly mood, behavioral changes, sleep disturbances, inattention, learning difficulties, etc. In some cases, compulsive ideas and behaviors appear early.

3. Characteristics of basic symptoms

(1) Clinical symptoms are closely related to age factors . The symptoms of younger people are atypical and monotonous; the basic symptoms of adolescent patients are gradually similar to those of adults.

(2) Most of the emotional disorders show loneliness, shrinking, indifference, alienation from loved ones and friends, or the development of hostile emotions for no reason. Unexplained fear, anxiety, and spontaneous mood swings.

(3) Cases with young children with speech and thinking disorders often show reduced speech, silence, repetitive stereotypes, vague speech, and poor thinking content. Older children may have pathological fantasy content, bizarre and whimsical delusions, and often have victimization, sin, suspicion, and non-blood delusions.

(4) Children with schizophrenia have more vivid and perceptive disorders, and are characterized by horror and imagery. They may have hallucinations, hallucinations (verbal or non-verbal), fantasy hallucinations, and cognitive impairment (such as Deformed, ugly, etc.), especially in young children.

(5) Movement and behavior abnormalities often show excitement, behavior disorder, purposeless running, or laziness, sluggishness, rigidity, less movement, or strange actions or postures, often imitating or ritualistic stereotypes. A small number of children show nervous stiffness and excitement, impulsive, hurtful, and disruptive behavior.

(6) Intellectual activity disorder is mainly seen in children with early onset. Most cases are generally without significant mental retardation.

Child Schizophrenia Test

Nervous system examination, electroencephalogram examination, skull CT scan, and magnetic resonance imaging (MRI) examination mainly exclude mental disorders caused by organic changes in the brain.

Child Schizophrenia Diagnosis

The main indications for the diagnosis of schizophrenia in children are as follows:

Symptom criteria

It has the basic symptoms of schizophrenia. It is mainly characterized by thinking disorder and affective disorder, and has obvious abnormalities and inconsistencies with the activity performance of the corresponding age behavior. At the same time, it has at least one of the following symptoms:

Poor thinking, loose or broken association, bizarre thinking content, pathological fantasy and delusion.

Indifferent emotions, lonely flinching, decreased interest, spontaneous mood swings, crying or anxiety for no reason.

Under the condition of clear consciousness, there are sensory disturbances, behavioral disturbances, psychomotor excitement, posture, violations or slowness.

2. Criterion

The ability to adapt is significantly impaired, and it is significantly abnormal compared with most normal children of the same age, including changes and deficiencies in interpersonal relationships, learning performance, labor and self-help in various situations at home and school.

3. Time Standard

The course of disease lasts at least 1 month.

4. exclude

Cerebral organic mental disorders, physical disorders, mental disorders, emotional disorders and developmental disorders.

Childhood schizophrenia often develops latently, progresses slowly, the symptoms are atypical, and the diagnosis is difficult, especially in young children. Therefore, careful examination and in-depth observation are needed. It must be distinguished from children with autism, mental retardation, hyperactivity disorder, character disorder, and organic mental disorder to avoid misdiagnosis or missed diagnosis.

Childhood schizophrenia complications

Symptoms such as emotional disorders, speech and thinking disorders, sensory disturbances, movement and behavior disorders, and movement disorders can occur.

Child Schizophrenia Treatment

The treatment of this disease is basically similar to that of adults. It mainly uses antipsychotic medication, psychological therapy and education and training. The choice of various treatments, in addition to the main clinical symptoms, also needs to be combined with the specific conditions of the patient, such as age, physical development, Take into account the nutritional status.

Drug treatment principle

It is advisable to start with a small dose, increase to a satisfactory therapeutic amount, and then gradually reduce it to a maintenance dose (equivalent to 1/4 to 1/3 of the therapeutic amount) for about one month, usually for more than half a year.

2. Commonly used oral antipsychotics

Chlorpromazine, perphenazine, sulpiride, clozapine, methiodazine, haloperidol, Vestone, trichlorothiazide (reconsole), piperidine, etc., the effective rate is 50% to 60% .

3. Long acting formulation

Can effectively maintain the efficacy of patients in the chronic phase.

4. Side effects of drug treatment

Extrapyramidal reactions are the most common side effects, which can be manifested as false Parkinson's reaction, inability to sit still, eye movement crisis, difficulty swallowing or speech, etc. Oral or intramuscular injection of scopolamine hydrobromide can be given orally. Hepatic impairment, granulocytopenia, orthostatic hypotension, drowsiness, constipation, lactation, pigmentation, amenorrhea, or sexual dysfunction can also occur.

5. Dietary care

(1) Children with schizophrenia should control high-calorie diets: Patients with schizophrenia are used to high-calorie diets. Antipsychotics improve the condition and increase appetite. Some patients do not know that they are hungry and full, and eat a large amount at a time. Therefore, the diet should be regular and quantitative, and according to the recipe. Studies have shown that casual intake of calories increases oxidative damage to brain cells, impairs learning and memory, and that schizophrenia patients tend not to exercise, so they are susceptible to obesity, hypertension, and diabetes, even if they do not take antipsychotics. The same is true with medicines, so patients with schizophrenia should control high-calorie intake.

(2) Stupid and offenders should persuade eating: give nasal feeding liquid foods, such as milk, soybean milk, porridge, fruit juice, vegetable juice, etc., if necessary. And prepare the right amount of meals at the bedside, so that you can get up and eat when no one is present.

(3) Victims of refusal to eat: In addition to persuading, food should be provided in closed packages, and family members can provide food that meets their tastes. However, it should be deployed according to doctor's orders to achieve a reasonable supply.

(4) The diet should pay attention to cooking methods and eat more green vegetables and fresh fruits: in order to increase appetite, supplement sufficient vitamins and trace elements.

Childhood Schizophrenia Prognosis

The onset is young, slow onset, and slow in progression; those with progressive development and mental retardation have a poor prognosis. Therefore, early diagnosis and timely active treatment are important to the prognosis of children with schizophrenia.

Childhood schizophrenia prevents recurrence of schizophrenia

The recurrence rate of schizophrenia is very high, and the more recurrences, the more severe the mental defect caused by the disease, which places a huge burden on patients, families and society. Therefore, once you have schizophrenia, you must do everything possible to take measures to prevent recurrence, that is, to take measures without recurrence.

1. Persist in maintenance dose medication

Is the most effective measure to prevent relapse. Most relapses in schizophrenia are associated with voluntary withdrawal. The relapse rate was 40% in patients who continued to take the medication, while the recurrence rate was as high as 80% in patients who did not maintain the medication. Therefore, patients and their families should attach great importance to maintenance treatment.

2. Find signs of recurrence in time and deal with them in time

The recurrence of schizophrenia is a precursor. As long as it is detected in time and the drugs and dosage are adjusted in time, it can generally prevent recurrence. The common precursors of recurrence are: poor sleep, laziness, unwillingness to get up, drowsiness, emotions Instability, irritability for no reason, irritability, cranky thoughts, outrageous speech, or sick thoughts showing up. At this time, you should seek medical treatment in a timely manner, adjust the treatment, and timely treatment when the condition fluctuates can avoid the recurrence of the disease.

3. Adhere to regular outpatient review

We must insist on regular re-examination at the outpatient clinic, so that doctors can continuously and dynamically understand the condition, so that patients are often under the medical supervision of a psychiatrist, and the dose is adjusted in time according to the change of the condition. Re-examination can also enable patients to receive timely counselling and psychological treatment, and relieve patients of various confusions in life, work and medication, which also plays an important role in preventing the recurrence of schizophrenia.

4. Reduce predisposing factors

Family members and those around them should fully recognize the weak state of mental state of schizophrenic patients, and help arrange daily life, work, and study. Talk to patients often, help patients to treat diseases properly, treat real life correctly, help patients to improve their psychological endurance, learn how to deal with stressful events, encourage patients to strengthen their confidence, guide patients to enrich their lives, so that patients have no psychological stress and mental distress Living in an environment.

5. Conduct community mental illness prevention

To detect patients early, treat them early, and prevent relapses, we must establish prevention and treatment institutions for mental illness in the society, and popularize knowledge on prevention and treatment of mental illness in primary health care organizations. Since the establishment of community psychiatric prevention and control institutions, the relapse rate of schizophrenia has decreased significantly.