Schizophrenia in children is extremely rare - statistics show that in childhood one child out of fifty thousand falls ill with it. However, the problem is aggravated by the fact that it is very difficult to recognize an ailment in early childhood, because it is not a physical disability that is immediately obvious. At an early age, the manifestation of the disease can go unnoticed, and after all, timely diagnosis could help a little patient. It is worth considering in detail the symptoms and signs of this disease in children.
Causes
Like any other disease, childhood schizophrenia is caused by certain factors leading to the development of the disease. At the same time, scientists have not been able to establish the full range of reasons - there are only factors that increase the risk of morbidity, but do not mean one hundred percent probability of such an outcome.
The main reason is considered a genetic predisposition, namely - violation of the gene structure. However, no one can say when this factor will play its role, because inherently congenital schizophrenia manifests itself only under the influence of a certain catalyst.
It is more likely to diagnose an ailment in a newborn soon after birth if the catalyst was an event that occurred while the child was still a fetus - for example, cord entanglement, mitochondrial insufficiency, other pregnancy pathologies and complications during childbirth.
In most cases, the first signs are observed much later, being caused by a viral infection of the nervous system or severe stress. Wherein the coincidence of even several of these factors does not mean at all that the child will develop schizophrenia.
As a disease of a genetic nature, schizophrenia is not transmitted in any way, except by inheritance.
At the same time, completely healthy children can be born to parents with gene disorders, and vice versa - the disease in a completely healthy family can first manifest itself in a baby who has received a gene disorder not as an inheritance, but as a result of his own pathology.
Signs in babies
In some cases, it is possible to determine obvious mental disorders in a baby even before he turns 2 years old. The most conspicuous symptoms are strange behaviors: for example, a clearly focused gaze literally from birth, as if the child was looking at a non-existent object. And this despite the fact that many babies just do not know how.
There are also opposite examples, when the child does not react at all to moving objects. Such children sleep very little - only a few hours. They react sharply to noise and cry more often than others - with general lethargy.
With the further development of the child, the pathology becomes more and more obvious. A typical sign of schizophrenia is delays in speech and motor development, although by themselves they still do not say anything. Awkwardness and slowness are very noticeable in movements, in addition, these children usually do not know how to build interpersonal relationships.
In general, the behavior of babies looks very eccentric... Their former lethargy, observed in the first months of life, is replaced by light excitement, a tendency to aggression and screaming, but at the same time - by comparative coldness towards their parents. Such a child is able to get carried away with his activities, up to obsession, and in games he usually does not look for company, and does not even think about the interests of others. Sometimes schizophrenia is accompanied by oligophrenic defect, which is characterized by low memory capacity and general naivety.
The course of the disease
If children become ill with schizophrenia, it usually happens at the preschool age. This especially complicates the diagnosis, since almost all of the named symptoms by themselves do not indicate schizophrenia, but are deviations within the normal range, because each child develops individually.
The situation is further aggravated by the fact that more than two thirds of all children with schizophrenia experience seizures. It does not manifest itself stably, while the continuous development of the disease is observed only in every fourth small patient.
Every third child with schizophrenia suffers from its malignant form, which is characterized by a high degree of concomitant oligophrenia.
For unknown reasons, boys are at particular risk - girls make up only a quarter of all patients of this type. In addition, it is in boys that the disease progresses, albeit sluggishly, but steadily, while girls are distinguished by more pronounced, but still not constant attacks.
Specificity of the malignant form
The malignant form of schizophrenia is rightly considered the most severe, since it not only slows down the development of the child, but literally turns him back. With the onset of the disease at a very early age, suspicious processes become noticeable already at the age of about a year - and take their final form by the age of 5-7 years. Although in especially severe cases, the formation of negative symptoms occurs very quickly.
First of all, noticeably general extinction of the emotional background... It is usually typical for babies not to lose heart, they quickly forget grievances and again enjoy life, but for patients with malignant schizophrenia, cheerfulness is alien. The child withdraws into himself, he is no longer interested in what is happening around him, even meeting with his parents does not cause him joy.
Playful activity is increasingly slipping into a primitive, childish inaccuracy not only does not disappear over time, but also gets worse. The kid does not perceive everything new so much that any changes can be almost the only factor that causes him strong emotions - negative ones.
Speech activity also drops. A child who speaks well begins to limit himself to short and simple phrases, then his pronunciation deteriorates, and then he may stop talking altogether. Regression also affects movements - even if the baby already knew how to dress himself, in terms of hand motility, he gradually returns to the level of a child 1-1.5 years old. Moreover, it is likely regular repetition of some simple, unconditional movement - like rocking.
With the continuous course of the malignant form of schizophrenia, the described regression is inevitable. If it manifests itself in the form of seizures, then these symptoms are present in two out of three small patients.
Catatonic symptoms
One of the most common comorbid disorders of schizophrenia is catatonia, that is, a clear impairment of physical activity. It is not always expressed in the form of a decrease in activity - instead of stupor, unreasonable excessive excitement may appear. Extremely abrupt "regime change" is also not uncommon.
If the amazing passivity is simply scary, then abnormal arousal has very specific risks, such as unjustified aggression and a tendency to impulsive actions. Tellingly, catatonic syndrome can develop on its own, without concomitant mental disorders. Its typical features are:
- Trampling on the spot, intermittent movements without a specific goal, or gait without a definite rhythm, somewhat reminiscent of driving a car with a novice driver who has not yet mastered the gearbox. This also includes many hours of chaotic walking, accompanied by a dispersed gaze, which does not prevent the patient from successfully avoiding any obstacles in his path.
- The situation when the child suddenly "turns off": he was just hyperactive and very mobile, and after a moment - already lies completely exhausted.
- Spontaneous awakenings in the middle of the night - without the ability to quickly fall asleep further.
- In especially severe cases - destructive hyperactivity, when a virtually unreasonably angry child is able to purposefully cause physical harm to himself and others, as well as to break any surrounding objects.
Perceptual disorders
A typical condition for most children with schizophrenia is indifference to what is happening around them. At the same time, indifference to literally everything is in sharp contrast to illogical, but very noticeable hobbies for some particular subject, occupation or topic.
It is also very characteristic hallucinatory perceptionwhen a small patient sees and tactilely feels something that is not really there.
Such irrational feelings cause fear in the child and often develop to the scale of a full-fledged phobia, which intensifies with the onset of the evening.
During the daytime, fear and distrust are also present, but they are more directed towards real-life objects - for example, unfamiliar surroundings or people. The child's anxiety is accompanied by the refusal to eat and play, as well as the desire to be as close to the mother as possible.
Experts have noticed that if fear is caused by a certain real factor, then its elimination generally improves the condition of the child.
The described symptoms also have outwardly pronounced features: open mouth and wandering, diffuse gaze. Continuous schizophrenia is one hundred percent guarantee of impaired perception, but more than a third of patients with paroxysmal form do not have such mental disorders.
Diagnostics
Since childhood schizophrenia is not an incurable disease, it is very important to diagnose it as early and accurately as possible. Even if the child cannot be cured in the end, it is only with the help of a correctly and timely diagnosis that one can at least partially reduce the detrimental effect on the baby of all the described symptoms. Moreover, most often, doctors confidently determine schizophrenia only at primary school age, up to 12 years, and even then - only based on the results of a large inpatient examination.
There are several difficulties that prevent the rapid detection of schizophrenia. Firstly, many symptoms of this disease may indeed be just traits of character or individual development. They do not indicate illness. Second, many mental illnesses share a very similar set of symptoms, but require very different treatments.
Thirdly, such a striking sign of mental disorders as hallucinations and false perceptions cannot be observed from the outside - only the patient himself can tell about this. At the same time, children of preschool age are already far from always capable of a detailed, detailed story, so also schizophrenia contributes to a decrease in speech activity.
In such situations, specialists usually carry out complex diagnostics, designed not so much to confirm schizophrenia itself as to check the possible presence of those signs that could indicate a different nature of the disease. As a result the initial diagnosis may change repeatedly, which reduces the effectiveness of treatment.
Often, even experienced doctors confuse schizophrenia with autism, because at the beginning of their development, they are really very similar. However, schizophrenia is more common manifests itself not earlier than 3-4 years, it is characterized by a gradual worsening of violations. Autism usually develops by the age of two and is a sharp degradation, but with subsequent development, albeit very slow.
At this point, you need to pay special attention, because the child himself will not tell this. The doctor does not have the opportunity to observe the patient as regularly as the parents do, therefore, he will base his conclusions on the words of the latter.
How to treat?
Doctors note that approximately half of children diagnosed with schizophrenia in preschool age have every chance of growing up to be healthy people. To treat this disease, a set of methods is used, a significant part of which was proposed by the famous Russian psychotherapist Vladimir Bekhterev about a hundred years ago.
Schizophrenia on tomography looks like developmental disorders of the frontal lobe of the brain, but there are many reasons for this, which complicates the treatment. The younger the child, the more difficult it is to put together the right program for him. The range of medicines allowed for children is very limited, and psychotherapy does not work enough for them due to an insufficient level of understanding of the language.
In preschool age, schizophrenia is usually not so much treated as contained - with the help of permitted drugs (in moderation). In any case, specialists must explain to the whole family what they are facing, what can be done in order to increase the chances of a positive outcome. Even a properly organized environment can have a healing effect. Treatment takes several years but when psychotherapy is activated at a certain age, the result becomes more and more noticeable, and the same stationary procedures do not need to be done so often.
Medication is often prescribed to treat schizophrenia sedative direction - for example, chlorpromazine and lithium preparations, which calm both the psyche and physical activity.
To expand the effect, they are supplemented with anticonvulsants, as well as antidepressants and antipsychotics.
A very important role can be played behavioral psychotherapy, where the child will be taught to independently cope with their own experiences and establish contacts with others. The general relaxing effect and the necessary positive emotional outburst are given by therapy in the form contact with animals... A specialized specialist - a speech therapist will help in restoring disturbed speech.
Tips for parents
Numerous reviews from parents confirm that the right atmosphere at home can make it easier for a sick child to progress the disease. Such a disease in a baby can be a serious challenge for parents. Many are simply afraid of their own child and try to hand him over to doctors.
With a typical symptom of this ailment (unreasonable phobias), family warmth and comfort are very important. Those families who do their best to provide the little patient with a happy childhood bring him much closer to recovery.
In order not to harm, but to help the child, adhere to the following rules:
- Children generally tend to invent non-existent things, but healthy kids do it consciously, and for patients with schizophrenia this is part of their reality. Trying to convince the child that his fears do not exist, you will only push him away, because he really sees what he is talking about.
- Since any changes in the life of a child with schizophrenia are perceived with hostility, find the conditions that suit him and make them a daily schedule that cannot be deviated from.
- Patients of this type are very closed in themselves, they are not interested in communication, but for recovery it must be provided. Parents will have to do this. You can do it yourself or with the help of a psychologist.
- When a child begins to realize that he is somehow not like that, it is necessary to provide communication with other families where there are children of the same kind. This will help both the kids themselves and their parents.
- Because of the high risk of severe fatigue, do not overwhelm your child with even rewarding activities such as school.
Thanks to the described actions, even in those adolescents who could not be cured, a strategy for adapting to their own unusualness is being developed, which allows them to go to a regular high school.
All about the symptoms and signs of schizophrenia in children, as well as its diagnosis and treatment, see below.
