Early signs and symptoms
The earliest indications of childhood schizophrenia may include developmental problems, such as:
- Language delays
- Late or unusual crawling
- Late walking
- Other abnormal motor behaviors — for example, rocking or arm flapping
Some of these signs and symptoms are also common in children with pervasive developmental disorders, such as autism spectrum disorders. So ruling out these developmental disorders is one of the first steps in diagnosis.
Symptoms in teenagers
Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be harder to recognize. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as:
- Withdrawal from friends and family
- A drop in performance at school
- Trouble sleeping
- Irritability or depressed mood
- Lack of motivation
- Strange behavior
Compared with adults, teens may be:
- Less likely to have delusions
- More likely to have visual hallucinations
Later signs and symptoms
As children with schizophrenia age, more typical signs and symptoms of the disorder begin to appear. Signs and symptoms may include:
- Hallucinations. Hallucinations can involve any of the senses, but these usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience.
- Delusions. These are false beliefs that are not based in reality. For example, you believe that you're being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; a major catastrophe is about to occur; or your body is not functioning properly.
- Disorganized thinking (speech). Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad.
- Disorganized or abnormal motor behavior. This may show in a number of ways. Behavior is not focused on a goal, which makes it hard to perform tasks. Abnormal motor behavior can include resistance to instructions, inappropriate and bizarre posture, a complete lack of response, or useless and excessive movement (catatonia).
- Negative symptoms. This refers to lack of or reduced ability to function normally. For example, the person appears to lack emotion, such as not making eye contact, not changing facial expressions, or speaking without inflection. Also, the person may talk less, neglect personal hygiene, lose interest in everyday activities or socially withdraw.
Symptoms may be difficult to interpret
When childhood schizophrenia begins early in life, symptoms may build up gradually. The early signs and symptoms may be so vague that you can't recognize what's wrong, or you may attribute them to a developmental phase.
As time goes on, symptoms may become more severe and more noticeable. Eventually, your child may develop the symptoms of psychosis, including hallucinations, delusions and difficulty organizing thoughts. As thoughts become more disorganized, there's often a "break from reality," frequently resulting in hospitalization and treatment with medication.
When to see a doctor
It can be difficult to know how to handle vague behavioral changes in your child. You may be afraid of rushing to conclusions that label your child with a mental illness. But early treatment will likely help in the long run. Your child's teacher or other school staff may alert you to changes in your child's behavior.
Seek medical advice if your child:
- Has developmental delays compared with other siblings or peers
- Has stopped meeting daily expectations, such as bathing or dressing
- No longer wants to socialize
- Is slipping in academic performance
- Has strange eating rituals
- Shows excessive suspicion of others
- Shows a lack of emotion or shows emotions inappropriate for the situation
- Has strange ideas and fears
- Has violent or aggressive behavior or agitation
These general signs and symptoms don't necessarily mean your child has childhood schizophrenia. They could indicate simply a phase or another condition, such as depression, an anxiety disorder or a medical illness that requires other types of evaluation.
Seek medical care as soon as possible if your child has a change in thinking, as these symptoms should be addressed right away. Signs and symptoms can include:
Feb. 28, 2014
- Having beliefs not based on reality (delusions)
- Seeing or hearing things that don't exist (hallucinations), especially voices
- Disorganized or illogical thinking
- Speech that doesn't make sense
- Schizophrenia spectrum and other psychotic disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed May 8, 2013.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com. Accessed May 8, 2013.
- Schizophrenia. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/schizophrenia/complete-publication.shtml. Accessed May 8, 2013.
- Fischer BA, et al. Schizophrenia: Clinical manifestations, course, assessment, and diagnosis. http://www.uptodate.com/home. Accessed May 8, 2013.
- Fischer BA, et al. Schizophrenia: Epidemiology and pathogenesis. http://www.uptodate.com/home. Accessed May 8, 2013.
- Stroup TS, et al. Pharmacotherapy for schizophrenia: Acute and maintenance phase treatment. http://www.uptodate.com/home. Accessed May 8, 2013.
- Mental illness and the family: Recognizing warning signs and how to cope. Mental Health America. http://www.nmha.org/go/information/get-info/mi-and-the-family/recognizing-warning-signs-and-how-to-cope. Accessed May 16, 2013.
- Factsheet: Schizophrenia in children. Mental Health America. http://www.nmha.org/index.cfm?objectId=C7DF8F81-1372-4D20-C84C5539FAB14576. Accessed Sept. 13, 2013.
- McClellan J, et al. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52:976.
- Facts for families: Schizophrenia in children. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Schizophrenia_In_Children_49.aspx. Accessed Sept. 13, 2013.
- Staying well when you have a mental health condition. Mental Health America. http://www.nmha.org/go/mental-health-month/staying-well-when-you-have-a-mental-illness. Accessed Sept. 13, 2013.
- Abidi S. Psychosis in children and youth: Focus on early-onset schizophrenia. Pediatrics in Review. 2013;34:296.
- Huxsahl JE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 30, 2013.