The article deals with the differential diagnosis of such diseases as childhood autism and childhood schizophrenia. Current views on the etiology and pathogenesis of childhood schizophrenia are outlined. Possibilities of full-fledged social adaptation for children suffering from schizophrenia are discussed, as well as possibilities of medication correction.
Given the growing prevalence of autism spectrum disorders in children, the role of their verification is highly relevant. Diagnosing autistic disorders in children requires a multidisciplinary approach built on the interaction of clinical and paraclinical methods, among which methods of comprehensive psychological diagnosis are of paramount importance.
A multidisciplinary approach and involvement of additional methods of complex psychological diagnostics in addition to basic psychopathological diagnostics will make a significant contribution to resolving issues of early diagnosis, clarifying pathogenesis, and conducting a differential diagnosis with a disorder such as childhood schizophrenia.
Let us dwell on modern views of the concept of childhood schizophrenia, differential diagnosis of childhood autism and childhood schizophrenia.
Schizophrenia (from Greek schizo – to cleave and phren – mind, intellect) (the term of E. Bleuler, 1911) is a mental disorder, proceeding with fast or slowly developing personality changes of a special type, such as decrease of energy potential, progressing introvertedness, emotional impoverishment, loss of unity of mental processes, etc.
The development of such a personality deficit is closely associated with the so-called productive symptoms and syndromes – neuro- and psychopath-like, affective, hallucinatory, catatonic, as well as the neurotic lapse of consciousness. The development of the disease without appropriate treatment, especially its pronounced forms, leads to distortion or loss of previous social connections, reduction of mental activity, sharp behavioral disorders, especially when delusions, hallucinations and other productive disorders are exacerbated.
It is worth bearing in mind that in both childhood autism and early childhood schizophrenia the same disorders are noted: along with pronounced introvertedness there are affective disorders, supervalued fascinations, unusual cravings and fears, and pathological fantasies.
Contemporary views of the causes of schizophrenia are based on the predisposition and stress model, which emphasizes the role of interaction between predisposition, stress and protective factors in development.
Predisposition factors include: genetic risk, lesions of the central nervous system, lack of conditions necessary for learning, pathological forms of family relationships. Stressors include events that increase the likelihood of schizophrenic episodes, in particular events that can affect the rest of the child’s life, such as the death of a close relative; or sources of chronic stress – such as rough treatment of the child in the family.
Schizophrenia can occur at any age. However, it is most often diagnosed in the young. Schizophrenia is extremely rare in children under the age of 12, increases in adolescence, and has a critical onset between the ages of 20-25. In boys, schizophrenia occurs at an earlier age (2-4 years) and is twice as common as in girls. However, these sex differences disappear in adolescence.
For quite a long time, the term “childhood schizophrenia” referred to a variety of disorders that had nothing in common with each other except a severe and chronic manifestation of symptoms in early childhood. Schizophrenics were often referred to as children with borderline symptoms or no psychotic symptoms at all, who by modern standards should have been diagnosed with autism or other developmental disorders.
Current research suggests that childhood schizophrenia differs from autism in a number of ways:
- The emergence of problems at a later age;
- less severe impairment in intellectual development;
- less severe impairment of social interaction and speech development;
- Hallucinations and delusions as the child gets older;
- periods of remission and relapse.