Mental diseases have always been difficult to treat and were a mystery even to scientists. Despite the many advances in medicine, these pathologies are still classified as complex ailments that cannot be fully investigated. Signs of mental illness can occur at any age. Often, they are diagnosed among children, adolescents and young adults. One of the most common ailments encountered in psychiatric practice is schizophrenia.
Unfortunately, despite a long study of this pathology, it still defies explanation. The childhood form of schizophrenia is not uncommon. In order to control the disease at least partially, it is important to diagnose it in time and be observed by a psychiatrist throughout life.
Schizophrenia in children: a description of the pathology
Childhood schizophrenia is considered a common mental pathology. On average, it affects about 1% of young patients. Such a high incidence rate is due to the fact that it is impossible to diagnose the disease before the development of the clinical picture. Also, it is impossible to assume the occurrence of schizophrenia during fetal development, especially in the absence of a aggravated anamnesis for this pathology. Some time ago, this diagnosis was made for almost any mental disorder that a child has. Currently, there are clear criteria that characterize this disease. Childhood schizophrenia refers to severe mental pathologies, characterized by a chronic and progressive course. Common symptoms of the disease are: behavioral and thinking disorders, changes in the emotional background, hallucinatory syndrome, catatonia, delusions, etc. Signs of childhood schizophrenia may be different. First of all, it depends on the form of pathology.
Causes of schizophrenia in children
There has been a lot of research done to find out why schizophrenia occurs. The childhood type of the disease is not much different from the adult forms of the disease. However, it has a worse prognosis due to early development. Despite the work of scientists, it was not possible to identify the exact cause of the onset of the disease. However, psychiatrists point to a number of factors that increase the risk of developing schizophrenia in children. These include:
- Burdened heredity for this disease. In most cases, there were people in the family of patients who suffered from schizophrenia. The risk of pathology increases not only in the presence of the disease in parents, but also among other family members. It was revealed thatthere is a special gene responsible for the development of schizophrenia.
- Adverse effects on the embryo during the laying of organs. The damaging factors include drugs, drugs, alcohol, ionizing radiation, chemicals. These effects are especially dangerous in the first trimester of pregnancy. Indeed, at this moment, the laying of the nervous system occurs.
- Late pregnancy. Conceiving a child at the age of 35 increases the risk of developing mental pathologies in the fetus.
- Chronic infectious diseases in a pregnant woman.
- Staying under stressful conditions. It is worth remembering that nervous strain while carrying a child affects not only the condition of the pregnant woman, but also adversely affects the fetus.
Despite the fact that the exact cause cannot be determined, it is worth taking measures to eliminate all risk factors.
Pathogeny of childhood schizophrenia
Given that the etiological factor has not been established with accuracy, the mechanism for the development of schizophrenia is also unknown. There are hypotheses according to which it is possible to partially explain the pathogenesis of this mental disorder. Schizophrenia in childhood has the following developmental mechanisms:
- Hypoxia of brain cells during the maturation of the nervous tissue. This implies local oxygen deficiency. During the diagnostic procedures in patients with schizophrenia, it was revealed that the cortical sections of the right hemisphere of the brain underwent hypoxia,thalamus, amygdala, temporal gyrus and prefrontal region.
- Genetic changes. Most scientists believe that mutations in the short arm of chromosome 6 play a role in the pathogenesis of childhood schizophrenia. In addition, there is information about other violations of the genetic code in patients. However, the data is not confirmed by large-scale studies.
- Changes in the activity of neurotransmitters. To a greater extent this applies to dopamine. It is believed that the transmission of impulses under the influence of this substance in patients with schizophrenia is accelerated. In addition, other changes have been identified. For example, a decrease in the activity of glutamate receptors caused by drugs (the drug "Ketamine") causes the development of signs of schizophrenia in he althy people.
It is believed that the pathogenesis of the disease is based on a combination of several factors. However, it has not yet been possible to establish a direct link between neuronal damage, changes in mediator activity and genetic theory.
Forms of schizophrenia in children
Children's schizophrenia, like adults, can occur in various forms. The type of pathology is established on the basis of the clinical manifestations of the disease. Often, children develop the following forms of the disease:
- Hebephrenic schizophrenia. This clinical variant is considered the most unfavorable. Its main manifestation is hebephrenic syndrome. It is characterized by senseless excitement, antics, negativism, and ridiculous outbursts of merriment. Children suffering from this formschizophrenia, are not amenable to education and training. The first signs of pathology appear at the age of 10-14.
- Simple schizophrenia. This form can develop at any age. In some cases, the first manifestations are noted in the school years. At the same time, the diagnosis is established: "early childhood schizophrenia". A similar variant of the pathology is characterized by the absence of productive symptoms (hallucinations, delusions). The characteristic manifestations of the disease are apathico-abolic syndrome and disinhibition of reflexes (hypersexuality, bulimia).
- Catatonic schizophrenia. This form of the disease is considered malignant. It occurs in 1-3% of patients. The features of this variant of schizophrenia include: mutism, negativism, disinhibition of primitive reflexes, copying behavior (echopraxia). Characteristic signs are: unnatural posture of the patient, increased muscle tone, catatonic excitement and stupor.
Another form of pathology is paranoid schizophrenia. It is characterized by the development of delusions of persecution, overvalued ideas, mental automatism (Kandinsky-Clerambault syndrome). Often, such manifestations of the disease occur in adults (25-40 years). However, the development of this form of pathology in children is not excluded.
Children's schizophrenia: symptoms and signs of the disease
Clinical manifestations of the disease can occur both at an early age and in adolescents. It is believed that up to 5 years the pathology is almost impossible to identify. However, in subsequent years, it is impossible to immediately diagnose:"childhood schizophrenia". Symptoms of the disease should be monitored for a long time. Only after that, if there are several signs of pathology, the diagnosis is established: "schizophrenia" with an indication of its form. Symptoms of the disease include:
- Apatico-abulic syndrome. It is expressed in the fading of interest in the usual activities (school, favorite activities, games), laziness, indifference to the opinion of parents.
- Hallucinatory syndrome. In addition to progressive isolation, the child can talk alone, perform some actions that imply the presence of the company (play with an imaginary friend, swear, have fun, etc.).
- Hebephrenic syndrome.
- Catatonia. With this form of the disease, such specific manifestations as a uterine position, an “air cushion symptom” are observed - when the roller is pulled out from under the neck and head, the patient’s position does not change. That is, he remains in the same position.
Signs of early schizophrenia may include: unmotivated crying of the child, screaming, mood changes, unwillingness to communicate, etc.
Features of pathology in adolescents
Signs of childhood schizophrenia in adolescence are somewhat different. In addition to these symptoms, patients have disinhibition of simple reflexes (increased appetite, sexual anxiety), delusions, pseudohallucinations may appear. Adolescents often become uncontrollable, refuse to communicate with their parents, commitantisocial actions. Patients stop attending school, express complete indifference to ongoing events, there is a disorder of thinking.
How does autism manifest itself in childhood schizophrenia?
Previously, autism was considered one of the criteria for schizophrenia in childhood. Currently, this disorder is isolated as a separate disease. Autism is a disorder in a child's ability to socialize. In addition, pathology is characterized by depletion or lack of emotional background and speech reactions addressed to others. Childhood schizophrenia is often accompanied by signs of autism. However, it is not the only manifestation of pathology and is mild.
Diagnosis of schizophrenia in children
Diagnosing schizophrenia is not always easy, as the disease can combine many of the features of other mental disorders. The undulating course of pathology (change of exacerbations and remissions) is taken into account. The diagnosis is made on the basis of the clinical picture and special psychological tests. At the same time, it is important to exclude harmful effects on the child's body (toxic poisons, drugs).
How to treat childhood schizophrenia?
Treatment of childhood schizophrenia is aimed at increasing the duration of remissions, stopping severe mental syndromes. Medicines from the group of neuroleptics (drugs "Eglonil", "Thioridazine") and nootropics are used. All patients are shown psychotherapy, as well aspreventive hospitalization and observation at least 2 times a year. To stop the hallucinatory syndrome, the drugs "Haloperidol" and "Triftazin" are prescribed.
Prognosis for schizophrenia in children
A favorable prognosis can be with a simple form of schizophrenia. Symptoms become less noticeable, the frequency of exacerbations is reduced. However, a complete cure is rare. With catatonic and hebephrenic form, the prognosis is unfavorable. Children suffering from these pathology options need constant care, they are assigned 1 disability group.
How to deal with a child with schizophrenia
It is quite difficult to communicate with a child suffering from schizophrenia, especially during an exacerbation of the pathology. Despite the desire to help, it is worth remembering that inappropriate behavior, aggression, or, on the contrary, even greater isolation can be provoked. Therefore, it is advisable not to reproach the child, and also not to point out to him that he is sick. Such children should be treated in the same way as he althy people so that they do not feel alienated. During an exacerbation, it is recommended to hospitalize the child in a hospital.
Prevention of schizophrenia in children
It is impossible to prevent childhood schizophrenia, but it is worth doing everything so that the child is born he althy. To do this, avoid stressful situations and adverse environmental influences. In the presence of pathology in relatives, it is necessary to be examined by a psychologist and genetics for both spouses before conceiving a child.
