Childhood Schizophrenia

Schizophrenia is a mental illness which affects millions of people throughout the world. Scientists have begun to understand more and more about the possible causes, predisposing factors, types, and possible treatments for schizophrenia. (Torrey, 1995) It is very rare for schizophrenic symptoms to appear before the age of 12 but it does occur. Recently, there has been a growing interest in childhood schizophrenia. It is less than one-sixtieth as common as the adult-onset type but the characteristics are very similar. Childhood schizophrenia also tends to be harder to treat and to have a worse prognosis than the adult-onset form. (Rapoport, 1997)

Childhood schizophrenia is seen as simply an early version of the adult-disease but it stems from a more severe brain disruption. (Bower, 1997) "Approximately two males are affected for every female. Only about two percent of individuals with schizophrenia have the onset of their disease in childhood". (Torrey, 1995) This depends on where the childhood-adult line is drawn. Schizophrenia beginning before age five is exceedingly rare, and between ages five and ten it increases slowly. From age ten, schizophrenia increases in incidence until age fifteen, when it begins its sharp upward peak as the adult disease. (Torrey, 1995)

There has been mounting evidence found that schizophrenia, similar to autism, has neurodevelopmental roots. More neurodevelopment damage has been seen in childhood schizophrenia than in the adult-onset type. Usually by age seven or later, many children with schizophrenia show delays in language and other functions. This occurs long before their psychotic symptoms develop, such as hallucinations, delusions, and disordered thinking. Research shows that 30% of these children show passing signs of prevalent developmental disorder in the first few years of life. They show display symptoms such as rocking, posturing, and arm flapping. (Rapoport, 1997)

The adult-onset schizophrenic patients have been observed in childhood home movies which indicate that they have unusual patterns of crawling and uneven motor development. Schizophrenic children are more seriously impaired because they are more anxious and disruptive than adult-onset schizophrenic patients were as children. (Rapoport, 1997)

Like adult schizophrenia, childhood schizophrenia is thought to have some genetic factors involved. "It is known that these children have an excess number of minor physical anomalies and mothers' history of having had excess pregnancy and birth complications". (Torrey, 1995) In cases where mothers were able to describe in detail their child's birth, it was found that most children with schizophrenia went through complications. These complications included five cases in which the expectant mother was hypersensitive, two of whom developed preeclampsia. Three of these children

were delivered by cesarean section. More complications included a delay in breathing, two babies were born with the chord around their neck, one child was 'held back until the doctor came,' and one mother had to have induced labor intravenously which required the baby to spend several days in the intensive care nursery. (Cantor, 1988)

Several factors have contributed to the onset of childhood schizophrenia. Many well-known infectious diseases such as rubella, cytomegalovirus, and herpes simplex virus have had a link. These diseases, with respect to brain development, can cause chemical imbalances which can start the onset to schizophrenia in childhood. Prenatal nutritional deprivation is another factor which can create schizophrenia in both male and female babies.

There has also been a big connection between influenza and schizophrenia. "Influenza rates are high in the winter and early spring. So are rates of schizophrenic births (the well-known season of birth effect)". (Eggers, 1991) The results from this study suggest that there are certain neurodevelopmental processes which are vulnerable to disruption during a particular period of pregnancy, and if disrupted, increase the risk of schizophrenic decompensation. It seems to be centered in the 6th-7th month of fetal

development, a period characterized by neuronal migration and especially rapid brain growth. (Eggers, 1991)

Once the child is born, there are many signs of the onset of schizophrenia. Major feeding disturbances occurred and children were described as having poor sucking ability or falling asleep every time the mother tried to nurse. (Cantor, 1988) The major sign is the mother-infant relationship. The child has no desire to cuddle with the parents or be held and create the bond that is so desperately needed. (Arieti, 1974)

The sleep cycle is often the first symptom to pre-schizophrenia. "Infants were reported to 'sleep almost constantly' during the first few months, yet by the age of six months, they refuse to sleep at all". (Cantor, 1988) Severe nightmares are very common in the first two years of life, where the child is unable to be awoken, or the child wakes spontaneously, vomits, and falls back asleep. (Cantor, '88) By the time the child is three or four, serious sleep disorders begin to develop. "The child just can't fall asleep, and it seems like they just can't relax". (Cantor, '88) These children are more likely to sleep walk, and have no fear in doing anything while in this state. "Both sleep behavior and understanding of danger improve as the child matures; in fact, schizophrenic children become cautious and fearful as the awareness of their alien world increases". (Cantor, '88)

Later on, the child's biggest problem is speech. Parents have often complained of loud, echoing speech, lack of speech, and slow development of speech and ability to express themselves. Other symptoms reported were the child crying for no reason, living in a world of their own, and ignoring everybody, even the mother. They also giggle and laugh for no apparent reason, but they won't talk. (Cantor, '88) As the child gets older, the main symptoms begin to form. These include odd behavior, stereotypes, visual and auditory hallucinations, bizarre thoughts, aggressive outbursts, severe anxiety, and fearfulness. (Sourander, 1997) Once these symptoms begin, they usually come and go for the rest of the person's life.

Children living with schizophrenia are usually very paranoid. They often have delusions which are fixed, false beliefs and may be followed by hallucinations that fit their delusions. The child tries to control every move of those around them. (Cantor, 1988) In latency and even in early adolescence, the delusions that are seen in childhood schizophrenia continue to be primarily delusions of identity: