Diagnosis

Diagnosis of childhood schizophrenia involves ruling out other mental health disorders and determining that symptoms aren't due to substance abuse, medication or a medical condition. The process of diagnosis may involve:

  • Physical exam. This may be done to help rule out other problems that could be causing symptoms and to check for any related complications.
  • Tests and screenings. These may include tests that help rule out conditions with similar symptoms, and screening for alcohol and drugs. The doctor may also request imaging studies, such as an MRI or CT scan.
  • Psychological evaluation. This includes observing appearance and demeanor, asking about thoughts, feelings and behavior patterns, including any thoughts of self-harm or harming others, evaluating ability to think and function at an age-appropriate level, and assessing mood, anxiety and possible psychotic symptoms. This also includes a discussion of family and personal history.
  • Diagnostic criteria for schizophrenia. Your doctor or mental health professional may use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Diagnostic criteria for childhood schizophrenia are generally the same as for adult schizophrenia.

Challenging process

The path to diagnosing childhood schizophrenia can sometimes be long and challenging. In part, this is because other conditions, such as depression or bipolar disorder, can have similar symptoms.

A child psychiatrist may want to monitor your child's behaviors, perceptions and thinking patterns for six months or more. As thinking and behavior patterns and signs and symptoms become clearer over time, a diagnosis of schizophrenia may be made.

In some cases, a psychiatrist may recommend starting medications before an official diagnosis is made. This is especially important for symptoms of aggression or self-injury. Some medications can help limit these types of behavior and restore a sense of normalcy.

Sept. 29, 2016
References
  1. 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 Aug. 2, 2016.
  2. Hales RE, et al. Schizophrenia spectrum and other psychotic disorders. The American Psychiatric Publishing Textbook of Psychiatry. 6th ed. Washington, D.C.: American Psychiatric Publishing; 2014. http://www.psychiatryonline.org. Accessed Aug. 2, 2016.
  3. 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 Aug. 2, 2016.
  4. Fischer BA, et al. Schizophrenia: Clinical manifestations, course, assessment, and diagnosis. http://www.uptodate.com/home. Accessed July 22, 2016.
  5. Fischer BA, et al. Schizophrenia: Epidemiology and pathogenesis. http://www.uptodate.com/home. Accessed July 22, 2016.
  6. Stroup TS, et al. Pharmacotherapy for schizophrenia: Acute and maintenance phase treatment. http://www.uptodate.com/home. Accessed July 22, 2016.
  7. How to cope when a loved one has a serious mental illness. American Psychological Association. http://www.apa.org/helpcenter/serious-mental-illness.aspx. Accessed July 19, 2016.
  8. Supporting a friend or family member with mental health problems. MentalHealth.gov. https://www.mentalhealth.gov/talk/friends-family-members/. Accessed July 19, 2016.
  9. Bustillo J, et al. Psychosocial intervention for schizophrenia. http://www.uptodate.com/home. Accessed July 23, 2016.
  10. Childhood schizophrenia. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pediatrics/mental-disorders-in-children-and-adolescents/childhood-schizophrenia. Accessed Aug. 2, 2016.
  11. Childhood schizophrenia. Merck Manual Consumer Version. https://www.merckmanuals.com/home/children-s-health-issues/mental-health-disorders-in-children-and-adolescents/childhood-schizophrenia. Accessed Aug. 2, 2016.
  12. McClellan J, et al. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry. 2013;52:976.
  13. Schizophrenia. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Accessed July 19, 2016.
  14. Jibson MD. First-generation antipsychotic medication: Pharmacology, administration and comparative side effects. http://www.uptodate.com/home. Accessed Aug. 9, 2016.
  15. Huxsahl JE (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 19, 2016.
  16. Atypical antipsychotic medications: Use in pediatric patients. Centers for Medicare and Medicaid Services. https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/pharmacy-education-materials/downloads/atyp-antipsych-pediatric-factsheet.pdf. Accessed Aug. 21, 2016.