Schizophrenia is a fairly common disease. It is diagnosed not only in adults, but also in children. What is the essence of this disease? Many parents do not know the answer to this question. Only specialists have an idea about the nature of the disease. So, schizophrenia in a child, symptoms, diagnosis and treatment of the disease are topics worth understanding.
Schizophrenia: deciphering the term and the prevalence of the disease
The above term refers to a disorder of the brain. With it, signs of schizophrenia appear: human behavior and mental functions are disturbed. Previously, this disease was called mental illness, insanity, insanity. In 1896, E. Kraepelin began to apply the concept of "dementia praecox" to the disease. Only since 1911 the term "schizophrenia" began to be used thanks to E. Bleuler.
Schizophrenia, according to statistics, affects at least 1% of the inhabitants of our planet. Approximately 10% of this number are children. They have a diseasemay occur at different ages. For this reason, experts divide the disease into groups:
- schizophrenia of early and preschool age;
- school age schizophrenia;
- schizophrenia of adolescence.
Causes of schizophrenia in children
The views of modern specialists on the causes of the onset of the disease are based on the model of predisposition and stress. In accordance with it, the interaction of predisposition with protective and stress factors in the process of development plays a huge role. Predisposition includes:
- transferring genes that can cause a child to develop a disease;
- pathological processes occurring in the central nervous system;
- lack of conditions necessary for learning.
Stressors are events that increase the likelihood of a child developing a disease such as schizophrenia. Symptoms often appear due to the death of a relative. Negative factors also include sources of chronic stress. An example is child abuse. It is worth noting that with a genetic predisposition, schizophrenia does not always develop. The disease appears with a sufficiently strong influence of stress factors and provided that the person does not have sufficient resources to resist the disease.
Features of schizophrenia of early and preschool age
Statistics show that about69% of children of early and preschool age, the disease begins before the age of 3 years. Schizophrenia in a child of 2 years may well appear. In 26% of babies, the disease develops between 3 and 5 years. In other children, the disease is diagnosed at 5-8 years. Schizophrenia is most commonly diagnosed in boys. Girls are less likely to experience this disorder.
Schizophrenia of early and preschool age is divided into several forms:
- malignant current;
- continuous-progredient;
- sluggish.
Malignant current form in early and preschool years
At the age of 1.5-2, such schizophrenia begins to develop in a child. Symptoms include a decline in mental activity, a decrease in interest in games, the disappearance of emotional attachment and the desire to communicate. The patient ceases to entertain himself with toys. His games consist of monotonous waving, tapping with non-game objects (pieces of iron, sticks, ropes).
About a year later, the malignancy of the course becomes more noticeable. Children stop answering questions, do not respond to separation. Their games become even more meager. In children, visual perception is disturbed, fears appear. After a couple of years, the condition of sick children may improve slightly. The severity of all observed suspicious symptoms decreases, excitement and fears disappear, sleep improves. An exacerbation of schizophrenia usually occurs during the second age crisis, at 7-8 years old.
Continuously progressive form in early andpreschool
This form of schizophrenia is characterized by the onset of symptoms of the disease at the age of 5-9 years. Children develop suspicion and incredulity. They may refuse friendship with other kids, arguing that they will take away all the toys. In some cases, there is a delusional attitude towards parents.
With the continuous-progredient form, children can involuntarily fantasize. With the disease, visual and auditory hallucinations appear. They are joined by experiences arising in a dream.
Lack of early and preschool schizophrenia
How to recognize schizophrenia in a child that occurs in this form? The disease begins during a 3-4-year crisis. Its occurrence is provoked by such psychogenic factors as parting with mom and dad, a change in the situation. The disease in a child develops slowly. The social circle is gradually decreasing. The child is in contact only with specific children. This is due to a decrease in the need for communication.
The following manifestations are still characteristic of the sluggish form of schizophrenia:
- loss of appetite;
- violation of the pace of speech;
- sleep disorders;
- unmotivated fears associated with fairy tales, fantasies, which subsequently often provoke the appearance of ideas of persecution.
A child breaks up with parents easily. Some children do not let go of their mothers and fathers, but such behavior is observed in them only because of the fears experienced. In some cases, children show signs such as cruelty,viciousness, aggression, sadism.
Peculiarities of schizophrenia in school-age children
Features of the psychological picture of schizophrenia in school-age children are that the disease occurs imperceptibly and proceeds slowly. Some patients have various fears. Children worry about their own lives and the he alth of their parents. In the beginning, the worries may be justified. Then they lose their meaning and are not associated with any events. Children lose interest in learning, games, delusional thoughts appear about the influence of otherworldly forces.
Other children get sick differently. They come up with their own fantasy world, which they depict in drawings. Patients are completely immersed in their fantasies, whisper something, grimace, and hardly switch to real events. These children play alone, demanding others to call them fake names.
Features of schizophrenia in adolescence
In some cases, precursors appear before the onset of the disease. They represent absurd behavior, inexplicable acts, depressive or manic attacks. A similar condition in children lasts from several days to several weeks.
After the precursors, schizophrenia in adolescents is provoked by serious conflicts with peers, scandals with parents, attempts at violence. The resulting disease proceeds in different ways. In some, activity decreases, interests disappear and emotional-will disorders. Others have obsessive fears, thoughts, desires.
Diagnosis of the disease according to ICD-10 criteria
For the disease "schizophrenia" a test that could be carried out in the laboratory and which would indicate the disease has not been developed. The diagnosis is made by doctors taking into account the criteria of the ICD-10 (International Classification of Diseases 10th revision). According to them, the disease must have at least 2 symptoms (from the last 5 signs listed below) or 1 clear symptom (from the first 4 signs):
- silent repetition of thoughts in my head;
- delusional perception;
- auditory hallucinations, the appearance in the head of other people's voices that discuss or comment on the behavior of the patient;
- crazy ideas;
- constant hallucinations of any area, accompanied by unstable or incompletely formed delusions without a clear emotional content, or constant overvalued ideas;
- broken speech without a single meaning;
- the presence of disorders such as freezing, agitation, lack of answers to questions asked, stupor, negativism;
- change in behavior, loss of interest in the outside world and communication with other people, isolation;
- presence of such negative symptoms as apathy, inadequacy or poverty of emotions, social isolation and social unproductivity.
Differential Diagnosis
Schizophrenia in adolescents and young children presents with symptoms that aremany other diseases, so differential diagnosis is necessary. The tasks of specialists include the exclusion of the presence of a somatic, neurological and organic mental disorder, toxic substances in the body.
If a child has schizophrenia, what should parents do? They need to see a specialist for a referral for a complete medical examination, including:
- inspection;
- general and biochemical blood tests;
- urinalysis;
- ECG;
- Drug screening and other tests (if needed).
Principles of treatment
The diagnosis of "schizophrenia" necessitates the use of a classical treatment regimen. It includes the following steps:
- pain therapy;
- stabilizing (aftercare) therapy;
- supportive care.
The purpose of stopping therapy is to eliminate the symptoms of the disease (delusions, hallucinations, psychomotor disorders). In the treatment used neuroleptics - psychotropic drugs. With stabilizing therapy, a drug is prescribed that was used at the first stage and had a positive effect. The neuroleptic is used at a lower dose until the symptoms are completely eliminated. Maintenance treatment is carried out with the same drugs that eliminated the manifestations of the disease, but in much lower dosages to prevent relapse.
Harms of therapy and the need for psychosocial treatments
The diagnosis of schizophrenia is a chronic disorder. Long-term prognosis for most patients is pessimistic. However, thanks to antipsychotic drugs, it is possible to achieve an improvement in the condition of patients. Antipsychotics are widely used in the treatment of schizophrenia in children. At the same time, the effect of drugs on the children's body has not yet been fully studied. The use of drugs sometimes causes serious side effects. Thus, treatment is far from a safe process, but it cannot be abandoned.
Harm from psychotropic drugs is one of the features of the treatment of the disease. The second feature is the need for the use of psychosocial methods of treatment. These include social skills training, family intervention, placement of the sick in special schools.
In conclusion, it is worth noting that schizophrenia in a child, the symptoms of which are varied, is usually a hereditary disease. However, studies show that not in all cases, at the birth of monozygotic twins, both children develop schizophrenia. This confirms that the likelihood of its occurrence is influenced not only by genetic factors. If symptoms of schizophrenia appear, you should consult a doctor. The disease requires diagnosis (for the disease "schizophrenia" a special test is not carried out in the laboratory, the clinical picture, complaints are taken into account, blood and urine tests are taken, additional studies are prescribed). The disease also needs long-term treatment and the use of anti-relapse drugs after elimination.symptoms.
