The initial stages of schizophrenia may be manifested by the child having problems concentrating, sleeping, studying, and avoiding social interaction. In childhood schizophrenia, hallucinations, paranoia, and delusions may also occur. The most common symptom seen in children with schizophrenia is auditory hallucinations, which occur in about 80% of cases with onset before age 11.
Visual hallucinations, delusions, and thought disorders also occur in 40-60% of children with schizophrenia. During the psychotic phases of the illness, children with schizophrenia may claim to have superhuman abilities or some people are constantly watching them. During a psychotic attack, the patient’s behavior may become unpredictable and he or she may exhibit a tendency toward aggression, autoaggression. Children with schizophrenia often have symptoms such as depression, behavioral problems and suicidal tendencies.
When diagnosing, keep in mind that schizophrenia can manifest itself differently depending on age. Delusions, hallucinations, and impaired logical thinking are extremely rare and difficult to diagnose before the age of seven. If they do occur, they may have a less complex structure than in adulthood and contain childish themes. It is sometimes difficult to draw a line between such pathological symptoms as delirium and ordinary fantasies, caused by imaginative play and characteristic of many young children. It is also necessary to take into account that unlike adults, small children can be uncomfortable and do not feel the disorganizing character of their psychotic symptoms. Therefore, children may not be able to distinguish these symptoms from their normal experiences if they manifest them early in development.
Patients diagnosed with schizophrenia are usually prescribed antipsychotic medications (neuroleptics). The antipsychotic effects are not immediately apparent, but usually the symptoms of the illness (agitation, strange associations, voices) subside after a few days or weeks.
Medications can help control psychotic symptoms in children with schizophrenia, but the need for psychosocial treatments including social skills training, work with the family, and placement in special schools is also widely recognized in practice. Current research shows that many people diagnosed with schizophrenia can live productive, fulfilling lives. Whether or not psychotic symptoms are present, people are usually able to live full lives with these symptoms, work, make relationships, and fulfill themselves in a variety of ways.
Obviously, here, differential diagnosis is extremely difficult and should be based mainly on features of the dynamics of the psychopathological symptomatology. The main diagnostic criterion when it is impossible to identify the onset of the disorder is a sign of development with a deepening and change of symptomatology, as well as an increase in personality changes. In early childhood autism, unlike early childhood schizophrenia, the clinical picture is more uniform and stable, being limited for many years to the same disorders and not complicated by the addition of symptoms of another register.
The distinction between early childhood autism and early childhood schizophrenia is not so much of academic interest, but plays a principal role with regard to the therapeutic position of the psychiatrist. If early childhood schizophrenia is an illness, then it, like any other illness, must be treated and treated in a timely fashion. At the same time, proper treatment of children with schizophrenia not only reduces the symptoms and creates conditions for corrective help and improvement of adaptation of the sick child, but also reduces the severity of the procedural personality defect. Having documented the diagnosis of childhood autism, parents of a schizophrenic patient, actively supported by non-medical specialists, often refuse to treat the child, wandering off in search of other therapies (diets, nootropics, bio-supplements, etc.). Finally, when they do ask to begin treatment, it is sometimes too late, when the period of the active course of the illness is over and only a specific personality defect remains.