15.Schizophrenia

15.1.What Is Schizophrenia?

Schizophrenia is a complex mental health disorder that can cause seriousproblems with thinking, decision-making, feelings and behavior. People withschizophrenia may have problems with talking to others and making sense ofreality. They may want to be by themselves for hours at a time and not talk toanyone. They may say they hear “voices” that no one else can hear.

People with schizophrenia have this disorder through their whole life andit can make it hard for them to enjoy being with other people or to keep a job.Treatments for schizophrenia are improving so that symptoms can often bemanaged and not interfere with daily life.

15.2.How Does Schizophrenia Start?

Schizophrenia does not have one known cause. It is believed that genes andthe environment both play a part in the start of this disorder. There is a 10percent higher risk of developing schizophrenia if someone in the family (aparent, brother or sister) has this disorder.

Many scientists believe that the cause of schizophrenia is complicated andthat factors in our environment such as viruses also are involved. Genes thatwe inherit from our parents along with the environment may interact to causeschizophrenia.

15.3.Who Has Schizophrenia?

Just over 1 percent of the people in the United States have schizophrenia.Men and women are at equal risk of developing schizophrenia, and it can happenat any age.

Most people develop symptoms between the ages of 16 and 25 and this canoccur suddenly, or there can be early signs of the disorder. Schizophrenia israre in children under 12 and can be very hard to identify in the early phases.People do not usually develop symptoms past the age of 45.

15.4.Signs and Symptoms of Schizophrenia

There are three kinds of symptoms (negative, positive and cognitive).People with schizophrenia may have mostly one kind or a combination ofsymptoms.

Negative Symptoms

Flat affect – when a person’s face does not show emotions when they speak

Not being able to enjoy life

Not wanting to be around other people

Not being able to start or finish activities

Positive Symptoms

Hallucinations – hearing or seeing things that are not there. Most commonis hearing voices that talk to a person about their behavior or warn them ofdanger that isn’t real. This symptom is called “psychosis.”

Delusions – beliefs that are not true and are often strange. They may bebeliefs that other people are trying to harm them.

Strange thoughts that others notice because when they speak they don’tmake any sense, they jump from one topic to another, or they stop talking inthe middle of a sentence for no reason.

Body movements that are repeated over and over and the person might seemto be agitated

Cognitive Symptoms

Having trouble using information to make decisions

Poor attention and not able to focus

Trouble with memory

Most Common Symptoms

The following are the most common symptoms of schizophrenia. If a child isat high risk for schizophrenia because of a known family history, you may lookfor early warning signs of schizophrenia that may include:

Trouble telling dreams or television from reality

Confused thinking

Detailed and bizarre thoughts and ideas

Fearfulness that someone, or something, is going to harm them or is “outto get them”

Hallucinations (seeing, hearing, or feeling things that are not real suchas hearing voices telling them to do something)

Delusions (ideas that seem real but are not based in reality)

Extreme mood swings

Anxious or fearful when there is no danger

Flat affect (no emotional expression when speaking)

Trouble with schoolwork

Social withdrawal (severe problems in making and keeping friends)

Disorganized or catatonic behavior (suddenly becoming agitated andconfused, or sitting and staring, as if immobilized)

Odd behaviors (an older child may begin acting like a younger child)

Poor personal hygiene (suddenly stops showering or caring about beingclean)

Are People with Schizophrenia Violent?

Violence is not a symptom of schizophrenia. People with schizophrenia maybecome violent if they believe that someone is planning to harm them. Substanceabuse may make symptoms of schizophrenia worse and may increase the likelihoodof violence. Substance abuse may also make treatment less effective, and aperson with a substance abuse problem may be less likely to seek treatment.

15.5.How Is Schizophrenia Diagnosed?

Children with schizophrenia behave differently from adults withschizophrenia and do not usually experience delusions or show cognitivesymptoms until the late teen years. The symptoms of schizophrenia may look likeother problems or psychiatric conditions. Always consult your child's physicianfor a diagnosis.

Schizophrenia in children and teens is usually diagnosed by a child andteen psychiatrist. Other mental health professionals usually participate in thecompletion of a comprehensive mental health evaluation to determineindividualized treatment needs.

15.6.Treatment for Schizophrenia

Your child’s doctor will make a plan for your child based on thefollowing:

Overall health and medical history

The kind of symptoms your child is showing and how severe they are

What medications, procedures or therapies that your child can tolerate

Schizophrenia is a major psychiatric illness. Treatment for schizophreniais complex. A combination of therapies is often necessary to meet theindividualized needs of the child or adolescent with schizophrenia.

There is currently no cure for schizophrenia. Treatment is aimed atreducing the symptoms linked with the disorder. When symptoms are particularlybad, a child with schizophrenia may need to be hospitalized. Types of treatmentthat may be helpful to a child or teen with schizophrenia may include:

Antipsychotic medications. This type of medication can be helpful for manyof the symptoms listed above. Some examples of traditional antipsychoticmedicines include haloperidol (Haldol), chlorpromazine (Thorazine) andfluphenazine (Prolixin). Newer antipsychotic medications, called atypicalantipsychotics, include risperidone (Risperdal), olanzapine (Zyprexa), ziprasidone(Geodon), aripiprazole (Abilify) and quetiapine (Seroquel). The most commonside effect that children report with the newer antipsychotic medicine isweight gain. Children taking these medicines are monitored for insulinresistance, which could lead to the development of diabetes.

Individual and family psychotherapy. Individual therapy may focus ondeveloping social skills. Family therapy may help family members cope with thechild's illness.

Specialized educational or structured activity programs (social skillstraining, vocational training, speech and language therapy, smaller classroomsize, modification of academic work)

15.7.Preventive Action for Schizophrenia

No one knows how to prevent schizophrenia at this time. The best we can dois to notice early signs and symptoms for a correct diagnosis. If treatment canstart when symptoms are mild, it can help improve the quality of life forchildren and adolescents with schizophrenia.

Treatment is most successful when symptoms of the first psychotic episodeare addressed quickly and properly. Studies suggest that early treatment maykeep the illness from getting worse and help reduce some of the long-termeffects of schizophrenia.

It is important to the success of the treated child or teen who isprescribed medications for the treatment of schizophrenia to keep taking themedicine as prescribed. Dosages and types of medications may need to beadjusted from time to time in order to stay effective. Always consult yourchild's physician for more information.