Schizophrenia is a mental health condition that usually appears after 16 years of age. Though less common, schizophrenia symptoms can arise in children, too.
Schizophrenia is a mental health condition that interferes with your ability to think clearly, manage emotions, make decisions, and relate to others.
Schizophrenia is relatively rare, occurring in about 1% of the U.S. population. Childhood-onset schizophrenia — which is diagnosed in children before age 13 — is even rarer, and as such, researchers don’t fully understand the condition yet, and it can be difficult to accurately diagnose.
If you feel that you or a loved one may be experiencing symptoms of early onset schizophrenia, keep in mind that the first step is diagnosis from a healthcare professional. There are effective treatments to help you and your child manage the symptoms and improve quality of life.
Yes, children can have schizophrenia. Adult-onset schizophrenia most commonly emerges between the ages of 16 and 30, but some people receive a diagnosis aged 13 or younger, when it’s considered childhood-onset schizophrenia.
The incidence of childhood schizophrenia is low, with a prevalence of around
In childhood-onset schizophrenia, children tend to exhibit problematic behaviors — such as disruptive behavior at school — around age 5 or 6, though caregivers might note these behaviors before school begins.
Schizophrenia can be difficult to diagnose for several reasons. For instance, it can be difficult to separate hallucinations and delusions from a child’s typical imaginative play. In addition, children find it difficult to articulate their internal and external experiences, making it tricky to work out whether they have symptoms of schizophrenia.
Because of the difficulties with accurately diagnosing childhood-onset schizophrenia, it’s unclear how common the condition really is. If the symptoms appear in childhood, you might not receive a diagnosis until later in life.
One of the first steps you can take to better understand childhood onset schizophrenia is to become familiar with the warning signs and symptoms.
Despite the early age of onset, the symptoms are similar to the symptoms of adult-onset schizophrenia, though there are some differences.
The symptoms of childhood-onset schizophrenia include:
- atypical behavior or speech
- atypical thoughts and ideas
- confusing television and dreams with reality
- confused thinking
- trouble in school
- extreme moodiness
- personality changes
- severe anxiety
- difficulty relating to peers or keeping friends
- withdrawal and increased isolation
- worsening personal care
Children’s delusions and hallucinations may be less elaborate than those of adults. Visual hallucinations are more common and should be distinguished from normal fantasy play.
Children are more prone to experiencing auditory hallucinations than adults. Of all the children who are diagnosed with schizophrenia, 80% experience specifically auditory hallucinations. Children usually don’t experience thought disorders until mid-adolescence or later.
Schizophrenia can involve a variety of symptoms that fall into these general categories in both adults and children:
- Positive symptoms. This includes delusions (fixed false beliefs), hallucinations (perceiving experiences that aren’t actually occurring), and atypical behavior.
- Negative symptoms.This includes flat affect, withdrawal, anhedonia (a decreased ability to experience pleasure from positive stimuli), and avolition (a decrease in motivated activity).
- Disorganized symptoms. Speech or behavior is difficult for others to understand, sometimes involving illogical thinking and atypical behavior or movements.
Note that there’s no single way or timeline that symptoms begin to emerge. The onset can be quick, but most people show a slow and gradual development of various signs and symptoms. Gradual changes may be more difficult to notice.
There isn’t just one cause of schizophrenia. Several factors may explain why you or a loved one is experiencing this mental health condition, including:
- Genetics. Heredity plays a strong role in developing schizophrenia. Your likelihood of developing the condition is higher if you have a close relative, such as a parent or sibling, with the disorder.
- Brain chemistry. Issues with certain brain chemicals, like dopamine, may contribute to schizophrenia.
- Environment. Environmental factors, even while in the womb, can increase the chances of being diagnosed with schizophrenia. These factors may include stressful living situations, living in poverty, and being exposed to viruses or nutritional deficits before birth.
- Pregnancy factors. Some pregnancy and birth complications such as hypoxia, prenatal and perinatal adversities (stress, infection, malnutrition), and maternal diabetes may be linked with schizophrenia developing.
Though the presentation has some differences in children, the diagnostic criteria are almost the same for adults and children.
Schizophrenia can be tricky to diagnose in children. One of the reasons is that it’s difficult to differentiate true hallucinations and delusions from typical imaginative play.
Many of us are familiar with the concept of an imaginary friend. In fact, a 2004 study reported that 65% of children under 7 had imaginary friends at some point during their lives.
But an imaginary friend — though resembling a delusion — typically isn’t evidence of an underlying condition.
Likewise, children with underdeveloped language skills may show similar speech patterns as those who are experiencing disorganized speech due to schizophrenia.
While there’s no cure, effective treatment allows you to manage your child’s symptoms and reduce their impact on their life.
There are a range of schizophrenia treatment options, and the best options vary among people. Your child’s clinician or psychiatrist will consider these factors when deciding the best treatment option:
- the child’s age, overall health, and medical history
- extent of the condition
- type of schizophrenia
- the child’s tolerance for medications or therapies
- the child and caregivers’ opinions and preferences
Many children and adolescents benefit from a combination of therapies. The types of treatment that may be helpful include:
- Medications, such as antipsychotic medications. These are used to treat schizophrenia in both adults and children.
- Individual and family psychotherapy.
- Specialized educational or structured activity programs which can include social skills training, vocational training, and speech and language therapy.
- Self-help and support groups.
While it can take some trial and error to find the optimal treatment combination, with the right plan, treatments can greatly improve a child’s quality of life.
If you suspect that someone is experiencing symptoms of childhood-onset schizophrenia, the first step is to reach out to a psychiatrist. An accurate diagnosis will allow you to find the optimal treatments.
If you still want to learn more about schizophrenia on your own, you can explore these resources:
- Schizophrenia & Psychosis Action Alliance. This organization is dedicated to people living with schizophrenia and related conditions. They offer self-help peer support. You can also call 800-493-2094 for more information on their programs and support.
- Early Assessment & Support Alliance (EASA). This organization aims to create opportunities for anyone who’s experienced psychosis. They maintain a national directory for psychosis treatment programs in the United States.
- Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA’s early serious mental illness treatment locator provides resources for people living with serious mental health conditions (like schizophrenia, psychosis, and bipolar disorder) and their families to find treatment facilities after recent onset.