Dr. Ballas Answers: Schizophrenia and Children
My child was just diagnosed with schizophrenia. What should I be prepared for? Are there any tools as a caregiver that I can provide?
This question gives me the opportunity to discuss some issues in the treatment of childhood onset schizophrenia. First, it should be mentioned that schizophrenia in children is extremely rare, occurring in approximately one out of 40,000 children. Schizophrenia typically occurs at age 25 in women and age 18 in men. It is a serious disease, and has been ranked worldwide as one of the leading causes of disability. I should next mention that schizophrenia in children is commonly misdiagnosed with other disorders (for example, pervasive developmental disorders which occur in roughly one in 500 children) before schizophrenia is identified and appropriately treated. It is important that an extensive medical and psychiatric evaluation is done on every child suspected of having schizophrenia, so more common disorders are not overlooked.
The treatment of schizophrenia depends on the severity of the symptoms and the developmental age of the child. During periods when symptoms of psychosis are very severe, hospitalization may be required. Higher dosages of antipsychotic medications are usually required and sometimes children respond well to the structured setting of inpatient psychiatric unit. As I’ve discussed in earlier bogs, antipsychotic medications can cause movement disorders, and there is some evidence that they occur more frequently in children. Fortunately, the newer atypical antipsychotic medications are less likely to cause movement disorders. These medications do, however, have other significant side effects. For example, several of the newer medications have been shown to cause substantial weight gain.
A problem that is often frustrating for patients and family members is that of recurring severe symptoms. Among other causes, worsening of psychosis can be due to patients failing to take their medication regularly. Relapses of psychosis could also be due to the natural course of the disorder. Sometimes psychosis can lead children to behave bizarrely or say frightening or nonsensical statements.
Several national organizations have information on childhood psychosis, and psychiatrists often spend a considerable amount of time explaining schizophrenia to parents to educate them on the nature of the disorder and the importance of maintenance medication to prevent worsening psychosis. Research has shown that family intervention programs may reduce the relapse rate, so it is important that parents talk to their child’s physician about what family therapy or reading would be helpful. A future blog entry can explore other issues surrounding childhood schizophrenia, including issues with school and interactions with other children.
Published On: December 06, 2006