Early childhood schizophrenia before 3 years of age. How to recognize schizophrenia in a child

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 a fetus - for example, an umbilical 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 at all mean 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 - a 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. The typical sign of schizophrenia is delays in speech and motor development, although in themselves they still do not say anything. Awkwardness and slowness are very noticeable in movements, in addition, such 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 get sick 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 account for 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 fading of the emotional background... It is usually characteristic 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 make him happy.

Playful activity is increasingly slipping into a primitive, childish inaccuracy not only does not disappear over time, but also worsens. The kid does not perceive everything new so much that any changes may 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 of 1-1.5 years. 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 arousal may appear. Extremely abrupt "regime change" is also not uncommon.

If 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 in place, intermittent movements without a specific goal, or gait without a certain 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 - he 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, in fact, an 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 extent 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 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 in more than a third of patients with paroxysmal forms, such mental disorders are not observed.

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 correct 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 identification 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, preschool children 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, but 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 parents do, so he will base his conclusions on the words of the latter.

How to treat?

Doctors note that about half of children diagnosed with schizophrenia in preschool age have every chance of growing up to be healthy people. A complex of methods is used to treat this disease, 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 yearsbut 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 very 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.

Numerous reviews of 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 the typical symptom of this ailment (unreasonable phobias), family warmth and comfort are very important. Those families who are doing everything 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 schizophrenic patients 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 like school.

Thanks to the actions described, even those adolescents who could not be cured are developing a strategy for adapting to their own unusualness, 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.

Childhood schizophrenia, being a mental illness, affects the brain systems, affecting the emotional and cognitive (cognitive) spheres. The disease is characterized by psychotic symptoms: thought disorder, inappropriate emotional responses, disorganized behavior, deterioration in social functioning, loss of will. Schizophrenia in children is a common mental illness that affects up to 1% of all children. Schizophrenia in childhood is marked by the manifestation of delirium, hallucinations. Children are disturbed by visions, voices that are not perceived by loved ones and people around them.

For a long time, the term "childhood schizophrenia" was used to refer to various disorders that had nothing in common with each other, with the exception of chronic and severe manifestation of schizophrenic symptoms in early childhood. Children were classified as schizophrenics if they had borderline symptoms.

Childhood schizophrenia is differentiated from autism in the following ways:

- there are minor violations in the intellectual sphere;

- there are not serious violations of social interaction, as well as speech development;

- hallucinations and delusions appear;

- stages of relapse and remission are noted.

Currently, based on the criteria used to diagnose schizophrenia in adults, the disease is diagnosed in children.

The childhood type of schizophrenia manifests itself in the following initial stages of the disease:

- the baby is experiencing problems that are associated with disturbed sleep patterns, study, concentration, and unwillingness to communicate;

- the course of the disease is marked by incoherent speech;

- the child sees and hears things that are not visible or audible to others;

- periods of improvement are soon replaced by the hardest relapses, which are marked by incoherent thinking and jumping from one thought to another without logical tracing.

The pathopsychological phases of the disease are marked by the confidence of children in the possession of superhuman abilities, they constantly think that they are being watched.

Pathopsychological features in the disease reveal themselves in unpredictability and manifestation, a tendency to.

Causes of childhood schizophrenia

Researchers of this problem do not have a clear idea of \u200b\u200bwhat causes childhood schizophrenia. All studies indicate that it develops in the same way as schizophrenia in adults. Scientists are still puzzled by the development of early childhood schizophrenia and are inclined to believe that environmental factors and genetics are likely to play a significant role in the development of the disease.

There are the following possible risk factors at an early age:

- the presence of relatives suffering from schizophrenia;

- late pregnancy;

- stressful living conditions (emotional or physical abuse, parental scandals, difficult parental divorce, stressful situations);

- viral diseases in the womb;

- a mother-to-be with severe malnutrition during pregnancy.

Symptoms and signs of childhood schizophrenia

This disease develops gradually, suddenness is not inherent in it. Patients have various disorders that precede the onset of pathopsychological symptoms. This disease provokes serious negative consequences in the general development and performance of the child in school. To establish a diagnosis, the symptoms of the disease must be noted continuously for six months. After their occurrence, the child has an inability to achieve the required level of results in the educational or personal sphere.

To diagnose schizophrenia, at least two of the following signs must be noted within one month:

- catatonia (immobility, stupor);

- disorganized behavior and speech;

- emotional depression;

- hallucinations;

- lack of will;

- alogy.

If delirium or hallucinations are noted, in which the child hears voices and images appear, then one of the symptoms is sufficient to establish a diagnosis.

Up to seven years of age, logical thinking disorders are often manifested, but hallucinations and delusions are rarely observed and they are difficult to diagnose. If they are noted, they have, in contrast to similar symptoms in adults, a less complex structure and include children's themes. Sometimes it is difficult to draw the line between delusions and fantasies, which were caused by children's imagination. It should be borne in mind that children do not feel or experience discomfort of the disorganizing nature of psychotic symptoms and, if they occur at an early stage of schizophrenia, children do not distinguish them from natural normal experiences.

So, childhood schizophrenia is noted in the following manifestations:

- delusion, which is expressed in disordered thinking, as well as strong beliefs that worsen the interpretation of reality;

- hallucinations - disorders of perception, when a child sees, hears, perceives something that does not exist in reality and is not present at the moment. The most common symptom observed in children is auditory hallucinations, which occur in 80% of cases in individuals who have reached the age of 11.

In 60% of schizophrenic children, thinking disorders, visual hallucinations (auditory, command, dialogue, religious, commenting, harassing, visual, tactile, somatic), delusions (transformations into animals, delusions of persecution, delusions of grandeur, delusions of relationships, somatic delusions, thought disorder).

The accompanying pathological processes and symptoms characteristic of this disease are noted: hearing disorders, depression, behavioral problems, suicidal tendencies.

Treatment of childhood schizophrenia

This disease needs help in the areas of psychiatry and at all possible levels of psychotherapy.

The Childhood Schizophrenia Forums encourage parents to focus on carefully selected inpatient care staff, as the experience of the staff and their highly qualified training will help to help the child recover.

Treatment of childhood schizophrenia involves the appointment of medications by a psychotherapist only after correlating the harm and benefits for the little patient. In most cases, the problem is solved in a psychotherapeutic way, in some cases the safest therapy is selected. Unfortunately, the complete healing of children with such a disease does not occur, however, there are methods to minimize the severity of symptoms, minimize the likelihood of recurrence of relapses, and improve.

The information provided in this article is intended for informational purposes only and cannot replace professional advice and qualified medical assistance. At the slightest suspicion that a child has this disease, be sure to consult a doctor!

Schizophrenia in childhood manifests itself differently than in adults.

For example, a significant advance in development is so important for the self-esteem of many parents that they cannot think of anything else.

Meanwhile, this phenomenon deserves close attention. Often it appears among the symptoms and signs of schizophrenia in children - severe mental disorder.

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The concept and characteristics of the disease

Schizophrenia means severe mental disorderarising due to violations of the logical coherence of mental activity and leading to the death of the personality.

Children suffer from this disorder much less often than adults.

Only one percent of babies in a hundred are susceptible to schizophrenia. However, the appearance of unusual moments in the development and activities of the child should not be ignored.

This is especially true of excessive isolation, unfounded fears, and even delusions and hallucinations. All this inevitably inhibits and distorts the development of a growing personality.

Key features

The situation is complicated by the fact that in children the signs of mental disorder are, as it were, erased, not as clearly expressed as in adults.

All patients symptoms are subdivided on:

• negative;
• productive.

The first group includes abnormal phenomena, gradually emerging as the little person grows. This is an irrepressible fantasy, delusional ideas, hallucinations.

In both children and adults, all symptoms of schizophrenia can be divided into productive and negative.

The second group of symptoms includes qualities outgoingin the course of the development of pathology (emotionality, interest in life).

A person withdraws into himself, focuses on thoughts and ideas that are only known to him.

Schizophrenia is often mistaken for oligophrenia... Their initial stage is in many respects similar: the child, for no reason at all, begins to regress in all respects.

Speech loses clarity and meaning, intelligence drops, the baby increasingly prefers to crawl on the floor or jump on all fours, although he used to walk like everyone else.

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Symptoms by age category

How to recognize schizophrenia in a child? The manifestations of the disease at different childhood ages have their own characteristics.

Early preschool age

For young preschoolers under 7 years old, monotonous actions, for example, walking around the perimeter of a room or running in a vicious circle, mindlessly shifting things from place to place, striking a pen or pencil on paper.

Kid cries often for no apparent reason, he is nervous, his mood is abruptly and for no apparent reason changed to the opposite.

Schoolchildren

Schizophrenia in a school-age child is indicated distorted perception, violation of mental activity.

The child either directly notifies about the overvalued idea, or demonstrates it with all his behavior.

Often he sets out a completely coherent chain - coherent from the position of pathological perception of cause and effect.

Often it seems to him that a threat hangs over his family, that in fact he is not raised by his real parents. The child cannot clearly explain his thought when describing objects constantly breaks down on secondary signs.

In adolescents

Girls and boys with a mental disorder are characterized by the so-called "metaphysical intoxication." This term is called groundless philosophizing, based on some ephemeral principles that have nothing to do with reality.

The patient does not accept his body, his characteristics, he seems to himself ugly, fat, short-legged, or vice versa, too long, although in reality this is not at all the case.

Standard adolescent maximalism and stubbornness in schizophrenia take pathological forms, the patient becomes, in the truest sense, an enemy to everyone.

This is often accompanied by grimaces, grimacing, deliberately "baby" behavior ().

Childhood schizophrenia - symptoms and diagnosis from Israeli doctors in this video:

Causes of occurrence

Unambiguously answer the question: where do mental disorders come from in children, such as schizophrenia, medicine cannot yet answer.

The official version is considered to be a complex of various factors that influence personality development:

1. Biological (individual characteristics of the development of the disease). It is believed that the likelihood of developing pathology is directly related to viruses (herpes; Epstein-Bar, rubella). This also includes genetic predisposition, immune and autoimmune characteristics. According to scientists, cannabiod poisoning is also one of the causes of schizophrenia.
2. Psychological... If a small person is overly focused on himself, withdrawn, unsociable, overly slovenly, passive, unreasonably afraid of something, cannot relate to events - this is a reason for contacting a psychiatrist.
3. Social (the tense situation within the family, life in big cities provokes mental pathologies).

One cannot judge the presence of a disease by one or even two factors. A number of phenomena indicate pathology. According to doctors, almost everyone is predisposed to this or that mental pathology.

But this does not mean at all that he is guaranteed to get sick. Conversely, a person can experience severe shocks, but never experience bouts of schizophrenia, since he is not predisposed to it.

Classification and clinical forms

Schizophrenia in children manifests itself in the form of:

• (too strong fantasies, delusions, obsessions, anorexia, pathological dissatisfaction with oneself, especially in adolescent girls);
• malignant(begins at an early age, is characterized by a sharp predominance of negative symptoms, loss of speech occurs);
• recurrent(hallucinations, delirium,);
• paroxysmal progredient;
• (the most common variant in children, very often coincides in characteristics with special giftedness, such children are ahead of their peers in several points of development and are even considered to be child prodigies).

Of course, if several signs are detected do not draw disappointing conclusions. Girls in adolescence are characterized by maximalism, they want to be only dazzlingly beautiful and nothing else. They do not yet fully realize that there are no perfect people.

But if a teenager refuses to eat, experiences constant stress, obsession with a problem, often non-existent, this is a reason to contact a psychiatrist.

Complications

The success of the treatment of schizophrenia, however, like any other disease, is due to the timeliness of seeking qualified psychiatric help. In her absence the disease progresses, leads to social maladjustment.

As the little person grows, other problems arise - this is a tendency to vagrancy, and to abuse alcohol and drugs. A schoolboy, even a good student before, begins to start studies and skips lessons.

Excessive desire for solitude, obsession with delusional ideas, often such children leave home, wander, become deviant.

Rising suicide risk... Treatment of advanced stages is much more difficult and does not always lead to a satisfactory result. The patient becomes disabled.

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Diagnostics

For diagnostics, specialists use number of methods:

• clinical;
• clinical and biographical;
• psychological.

The psychiatrist talks to the baby, observes his games, analyzes his actions, way of thinking, drawings.

For the test, the child is asked to draw something on a piece of paper. The plot is usually free. So little man expresses his feelings, reveals the most characteristic tendencies of the disorder (see photo). Signs indicate pathology:

By itself, the drawing will not answer the question of whether the baby is sick or not, it only acts as a kind of malfunction indicator in the body.

Treatment

Schizophrenia can be cured with medicines(antipsychotics) and psychotherapy. The latter happens:

• individual;
• group;
• family.

It is a complex of corrective measures that are considered effective, which compensate and help restore communication skills in society.

With timely access to medical care, about a quarter of patients forget about seizures forever. Relief of seizures even with a serious degree of development of schizophrenia, it almost always guarantees a relapse.

Treatment takes place mainly in a hospital, since the behavior of patients is often deviant and threatens not only other people, but also the patient himself.

When the acute condition is suppressed, stabilization- at least five to six months (it is no coincidence that they talk about autumn and spring exacerbations), but sometimes it stretches for a year or even more.

Only the attention and support of the patient from the family and doctors guarantee a long remission and reduce the risk of relapse.

The forecast is favorable only with timely measures taken. According to doctors, the most optimistic prospects are for patients in whom schizophrenia manifested itself suddenly.

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Features of education and social adaptation

Rehabilitation measures for a schizophrenic child are aimed at returning to their previous life and preventing relapse. Children are sent to special schools, workshops, and creative associations.

Also possible return to old schooland the previous training program. This approach requires the constant involvement of a mentor - a social educator or psychologist.

Prevention

All risk factors for schizophrenia, of course, cannot be ruled out, but every parent can do it improve the atmosphere within the family, build trust, respect and love your child.

The beneficial effect of systematic visits by schoolchildren to a psychologist and classes with him is noted.

Schizophrenia is a mental disorder for which the most pronounced disturbances in thought processes, emotional sphere and perception are most characteristic. According to statistics, men and women get sick with approximately equal frequency, while women are characterized by a slightly later manifestation of the disease. Adolescent schizophrenia is quite common, while childhood schizophrenia is extremely rare.

The symptoms of schizophrenia can be extremely varied, but still three groups of signs are generally accepted:

1. Positive (productive) symptoms - obsessions, hallucinations, delusions.
2. Negative symptoms are apathy, abulia (lack of will), a gradual loss of the so-called higher emotions and a gradual decrease in emotional responsiveness, poor speech, loss of the ability to enjoy.
3. Cognitive dysfunctions - thinking disorders, difficulty concentrating, various memory problems.

Diagnostics

The diagnosis is usually made on the basis of the data obtained in the process of interviewing the patient.

while also the behavior of the patient. If possible, the patient's story is supplemented by relatives, work colleagues or friends . Schizophrenia in children and adolescents requires careful questioning of parents, as well as checking the possibility of a hereditary origin of the disease.

A highly informative research method is magnetic resonance imaging, which allows you to detect changes in brain activity typical for schizophrenia, as well as to exclude the tumor origin of disturbing symptoms. It is also recommended to conduct a complete medical examination for the purpose of differential diagnosis with somatic diseases, during which psychotic manifestations are possible.

The first manifestations of the disease in children

The first signs of the disease can be detected even in the first year of life, but most often the manifestation occurs at the age of 6-7 years. How schizophrenia manifests itself in children depends on the age at which the disease appeared. At the age of one to three years, signs of illness in a child may be: laughter that has no explanation, or vice versa, gratuitous tears, monotonous motor excitement - running in a circle or in an indefinite direction, aimless walking from side to side. At the same age, another disease with largely similar symptoms may appear - early childhood autism. RDA and early childhood schizophrenia have the following differences:

In preschool children, this disease can be suspected by a noticeable "dulling" of emotions - there is no change in voice intonation and facial expression, even in cases that normally should cause a strong emotional response. A situation in which a healthy person would laugh, cry, experience fear or surprise, to a schizophrenic patient seems simply uninteresting and not worthy of attention.

Symptoms of schizophrenia in children can also include:

• The appearance of neologisms in the child's speech;
• The simultaneous emergence of several rows of thoughts that are in no way connected with each other;
• Conflicting judgments;
• Difficulty making generalizations if necessary;
• Incoherent thinking;
• Indifference to your appearance;
• Apathy, unwillingness to do anything.

Drawings of children with schizophrenia are also noteworthy. Some characteristic features make it possible to suspect this disease at almost any age.

Drawings made by patients with schizophrenia may have the following features:

• Constant repetitions of the same objects, images, the patient is often repeated in his drawings in one way or another;
• If we look at several pictures, then quite often you can notice that the plot of one of them penetrates into the plot of the other;
• The pictures may contain symbols that are understandable only to the patient;
• Living beings in the drawings of patients with schizophrenia are often represented by non-existent animals;
• If the drawing is colored, then the unusual combination of colors and the unnatural coloring of the depicted objects attracts attention;
• The abundance of incomplete, often incoherent elements in the drawing;
• Sometimes the patient may be irritated by a certain color, most often black or red.

Features of the manifestation of the disease in adolescence

In the case of adolescent schizophrenia, teachers often notice the first signs of the disease - they note a sharp decline in school performance, a loss of interest in sports, social activities, and a change in the range of interests. Patients begin to ignore basic hygiene procedures and lose interest in their favorite hobbies. The problem of alcoholism and drug addiction deserves a separate mention - on the one hand, the intake of alcohol and drugs can provoke the development of the disease, on the other hand, schizophrenic patients sometimes try to reduce negative symptoms with drugs or alcohol. The effectiveness of such drugs is very doubtful, to say the least - under the influence of amphetamine-type drugs, the symptoms of schizophrenia are usually exacerbated.

Signs of schizophrenia in a teenager can also include:

1. Sudden unreasonable mood swings;
2. Unreasonable nervousness, anxiety, aggressiveness;
3. Excessive agitation, or vice versa, a depressive state;
4. The rapid appearance of negative emotions;
5. Loss of appetite (in the absence of pathology of the digestive system);
6. With the progression of the disease, hallucinations and delusions are added.

Treatment

The patient can be treated both at home and in a psychiatric hospital (usually inpatient treatment is needed only during an exacerbation, when the patient can be dangerous both for himself and for others). The treatment uses an integrated approach - a combination of pharmacotherapy, psychotherapy and social adaptation. Depending on the prevailing symptomatology and the characteristics of the course of the disease in the treatment of schizophrenia, drugs of such pharmacological groups as anxiolytics (the more common name is tranquilizers), antidepressants, hypnotics, nootropics and neuroleptics can be used. The selection of specific drugs and their dosages is carried out by the attending physician individually for each patient.

Also, most specialists note a significant improvement in the quality of life of patients who have undergone courses of psychotherapy and social adaptation. Self-help groups make a significant contribution to the treatment of schizophrenia, according to patients. Not the last role in improving the quality of life is assigned to the patient's relatives, whose task is to create a favorable emotional background.

On the one hand, schizophrenia in children is diagnosed much easier than in adults, since they still do not know how to hide their experiences as adults.

On the other hand, with an early onset of the disease, the child's inner world is still very poor and habitual pathological fantasies are not observed. Schizophrenia in children is not an independent disease, but an early form of common schizophrenia. The disease has a hereditary nature and often no external visible causes of its onset are noted. If there were patients in the family suffering from this disease, then the likelihood of its occurrence in descendants increases. Depending on the closeness of kinship, the possibility of manifestation of the disease ranges from 2 to 13%.

Forms of childhood schizophrenia

Most often, children have hebephrenic and catatonic forms of schizophrenia. The ratio of other forms of manifestation of the disease is much lower.

• Hebephrenic schizophrenia has a continuous course and rapid development. Delirium and hallucinations are poorly expressed, but will and emotions suffer greatly. It is difficult for a child to collect his thoughts, there is no desire for consistent action. Foolishness and inappropriate antics are observed in the behavior of such children. They make a lot of noise. Emotions quickly change from aggression to obsessive goodwill and vice versa.
• Catatonic schizophrenia is very different from other forms of the disease. At the first stage, babies make monotonous movements with their hands or toys for no apparent purpose, avoid communication and huddle under the bed or in the corner of the room. Then comes the stupor phase: children freeze in unnatural positions, the muscles are in a state of tension, not responding to external stimuli. The patient's look is confused, the emotions on the face clearly do not correspond to the environment. Sometimes the child's muscles become flexible, he can take the pose that is given to him. The stupor is replaced by a phase of acute excitement, with aggression directed at the first oncoming person or by irregular rapid movements.
• The simple form of schizophrenia usually begins in adolescence. It flows smoothly, continuously, without pronounced delusions and hallucinations. The onset of the disease can manifest itself in the form of unusual hobbies and a love of meaningless reasoning.
• With age, young people become more and more withdrawn, lack of initiative, their emotional reactions become impoverished. There is no attachment to parents and other family members, social activity in the form of a desire to study, create a family, search for work, and creativity is practically zero. Even if they go to college at the behest of their parents, they quickly lose interest in their studies. Fruitless philosophizing on the world order is primitive and has no connection with reality.
• A rare form of schizophrenia, but also manifested in childhood, is pfropfshizophrenia. It is sometimes called the grafted form of schizophrenia. It is a combination of symptoms of schizophrenia and mental retardation. The early development and rapid progression of the disease leads to lethargy and apathy already in adolescence.

How to avoid childhood schizophrenia

The only effective prevention of childhood schizophrenia is the responsibility of women with schizophrenia and their loved ones for the consequences of wanting to have a child. There is an expression: "schizophrenia arises on the mother's lap", that is, the character traits of one of the parents and the methods of handling the child can lead to such a state of the baby's psyche, which is called "readiness." It is known that the risk of getting sick increases in children with burdened heredity and various pathologies of perinatal development. Such children need the true love of their parents, the development of real human values, learning the right attitude towards themselves and those around them.

Symptoms of childhood schizophrenia

Childhood schizophrenia can begin as early as school age. Cases in the world psychiatric practice of diagnosing the disease in babies under 5 years old are rare.

Most likely, it will be appropriate to talk about childhood autism, which in adulthood usually changes to a diagnosis of schizophrenia. The main symptoms of schizophrenia in children are:

• Unusual fantasies: the child invents his inner world, completely cut off from the familiar world, and he endows the fairy-tale characters with incredible possibilities that do not have any reflection in the surrounding reality.
• Volitional decline: the child becomes indifferent, lethargic and apathetic, loses interest in communication, group games, his own entertainment becomes more like rituals with the same object. Such children gradually withdraw into themselves, it is difficult to call them into contact, they answer questions reluctantly and in monosyllables. They spend a lot of time alone, sitting in the corner of the room or in bed, covered with a blanket over their heads.
• Depletion of emotions: at first, in children with schizophrenia, inadequate emotional responses are noted - an attack of strong aggression can occur on insignificant occasions, and what should shock a healthy child does not cause any response. Over time, warm feelings for parents and friends are lost. A sick child does not care what he is wearing, the skills of self-care are lost. He does not rejoice at anything and does not grieve about anything, gradually losing interest in the external manifestations of life.
• Pathology of thinking: the child begins to study worse, does not readily attend school, the desire for cognitive activity is lost. Older children may experience visual and auditory (less common) hallucinations, especially often after sleep or at night. They say that they see a "black wolf" or "yellow threads", and, moreover, these objects always frighten the child, cause alarm. The patient begins phobias associated with fear of death or fear of sleep. The speech of children becomes strange, there are many invented words, abstruse and fanciful expressions. During periods of exacerbation, children begin to speak incoherent words, speech flows in a continuous stream, the child cannot stop.

Case history patient N., 7 years old

Boy N., 7 years old, came to the appointment with his mother. The child is gloomy, withdrawn, according to the mother, suffers from disturbances in night sleep - does not sleep, there is trembling in the whole body, an expression of fear on his face. The mother's attempts to ask the child about the nightmare end in a violent negative reaction with tears and screams. During the day, the mother did not notice anything special, except for some tiredness of the child, explained by lack of sleep. During the examination, it turned out that the child's motor function is not impaired, he answers the doctor's questions reluctantly, is silent until the doctor asks the next question, then answers in monosyllables. The function of thinking suffers, when asked why he combined pictures with the driver, fruits and dishes, he replied that these items belong to the driver. Diagnosis: low-grade schizophrenia. After treatment at home, the hallucinations stopped, the child's condition is good, home teaching is recommended.

Differential diagnosis

Only a pediatric psychiatrist can diagnose childhood schizophrenia, since there are several other pathologies, the symptoms of which are similar to schizophrenia. For example, autism, psychosis with infections and intoxication, schizotypal and schizoaffective disorders, schizoid character accentuation and a number of other mental illnesses. The differences between schizophrenia and autism are as follows:

1. 1. Schizophrenia always occurs with periods of exacerbation and remission.
   2. Delusions and hallucinations are common in schizophrenia.

Wait, please

1. Schizophrenia leads more to emotional-volitional decline, and autism leads to social isolation.

It is necessary to diagnose childhood schizophrenia as early as possible, since this period of life requires the acquisition of the necessary knowledge and the formation of personality. For an accurate diagnosis, determination of the form and course of the disease, as well as the selection of the necessary medications, the child must be hospitalized in a children's psychiatric hospital. It is impossible to make a mistake with the diagnosis at such an early age, since the further life of the child depends on it. Without accurate diagnosis and adequate treatment, this ailment can lead to social isolation and even loss of self-care skills.

How to deal with the disease

Childhood schizophrenia should be treated only under the supervision of a psychiatrist, who will prescribe a comprehensive treatment: drug therapy and psychological assistance as part of the child's social adaptation. If a child is in a state of psychosis or this is his first visit to a child psychiatrist, treatment takes place in a hospital. In this case, the task of the parents is to protect the child from possible additional experiences. It is impossible to predict a full recovery or the onset of personality destruction, since the child's body is in a state of development and growth. On the one hand, it complicates the course of the disease, on the other, it gives a chance to compensate for negative manifestations. From loved ones, the baby is required to create an atmosphere of love and care, which will prolong the periods of remission.

Where to go and what to do

A neurologist monitors the mental development of babies under 5 years old. In case of strange behavior and other unusual mental phenomena, it is necessary to refer to him. The diagnosis and treatment of mental pathology in children over 5 years old is the responsibility of a pediatric psychiatrist.

If the parents notice anything unusual in the child's behavior, then it is advisable to go to a psychiatric clinic without delay and unnecessary doubts. The advantage of the Preobrazhenie clinic is that patients are admitted absolutely anonymously, which is very important for the family. Qualified psychiatrists with extensive knowledge in various branches of psychiatry and psychotherapy are the pride of the clinic. The little patient will be examined quickly and imperceptibly for him, in a warm, cozy atmosphere, and treatment will be prescribed. They will have a conversation with the parents, teach them how to cope with the difficult nature of the baby, and predict the beginning of the next attack in order to prevent it in time.

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