Schizophrenia is a serious mental health condition that distorts your sense of reality.
It’s usually diagnosed in the late teens to early 20s in men and late 20s to early 30s in women, but symptoms can appear during childhood.
Recognizing the early warning signs may mean you can get help for a child in your care. Early treatment won’t cure schizophrenia, but it can lead to better
This article explains what schizophrenia can look like when symptoms start in childhood. It also discusses how the disorder is diagnosed and treated in children.
Schizophrenia is a mental health condition that interferes with a person’s ability to:
- manage their emotions
- think clearly
- make decisions
- relate to other people
It’s caused by a complex blend of environmental and genetic conditions. It tends to run in families. Environmental factors, such as poor nutrition during pregnancy and exposure to viruses before birth, may also have an influence on who develops the disorder.
It’s rare to see schizophrenia in children younger than 12, but it does sometimes happen. The condition can be hard to recognize in children because early symptoms can be confused with
- Withdrawing from people and social situations. This symptom is also linked to
autismand a number of other more common mental health conditions like anxiety or depression.
- Showing extreme fear that someone or something could harm them. Similar fears can sometimes worry children with obsessive-compulsive disorder (OCD) and childhood trauma.
- Other physical symptoms. Lupus, head trauma, low blood sugar, substance use, and seizure disorders can all cause symptoms that resemble some of those of schizophrenia.
Children with schizophrenia have the same symptoms as adults with the condition.
It’s often hard to diagnose schizophrenia in teens because early symptoms may look like teenage transitions and may include things like:
- lower grades
- a change in friends or social group
- difficulty sleeping
- other rather common behaviors of adolescence
Hallucinations are sensory events (seeing, hearing, smelling, or feeling things) that are not really there. This isn’t the same thing as playing with an imaginary friend or having common childhood fantasies.
Unusual thought or speech patterns
Schizophrenia can cause people to have trouble organizing their thoughts. Their speech patterns can also be disorganized, rambling, or disconnected.
People with schizophrenia may have delusions that cause them to cling to ideas that are not rational or realistic. They may have beliefs that are not based in reality, such as believing that others are plotting against them or trying to harm them.
Unusual movement patterns
Some people with schizophrenia pace, gesture, rock, or make other movements over and over.
In rare cases, people may experience catatonia, which involves behaviors, such as:
- not responding to stimuli
- not moving
- difficulty speaking or not speaking at all
- imitating others’ speech or movements
- refusal to eat or drink
Children with schizophrenia often have problems with concentration, focus, attention, memory, and decision-making. These symptoms can make it hard to function in school or in social settings.
Negative symptoms refer to the lack of certain abilities or skills. For example, some people with schizophrenia have trouble:
- showing emotion through facial expressions and tone of voice
- interacting with other people socially
- following through on plans and activities
- keeping up energy levels, sometimes becoming listless or passive
It’s important to know that children can have symptoms such as the ones on this list without developing schizophrenia.
Yes. Some symptoms may remain steady. Others may become more noticeable as your child gets older, especially if the condition hasn’t been treated. Schizophrenia symptoms can have quieter and more active periods throughout life.
Before a healthcare professional can diagnose a child or teen with schizophrenia, they’ll likely try to rule out other explanations and conditions. To do that, your child may need a combination of:
- a thorough medical exam
- a detailed medical history
- cognitive (thinking) tests
- urine tests
- blood tests
- liver and kidney function tests
- thyroid tests
- imaging scans of the brain
A key part of diagnosing schizophrenia in children is a psychiatric evaluation. This evaluation involves things like:
- observation of how the child looks and acts
- talking to the child to determine their thoughts and feelings
- identifying behavior patterns
- speaking with family members or other caregivers
- identifying thoughts or acts of self harm
- assessing mood and symptoms of anxiety or psychosis
Undergoing this many tests can be hard for children and families. There can be periods of waiting, and the stress can feel unbearable.
It’s important to be sure about a diagnosis, however, because the sooner the right diagnosis and treatment begin, the better the results are likely to be.
Once you and your child’s healthcare team are sure of the diagnosis, you can begin to build a treatment plan. You’ll need to decide:
- which treatments are right for your child
- which symptoms to prioritize
- what resources and support you, your child, and your family will need during treatment
The exact treatment will depend on the answers to questions like these:
- How severe are the symptoms?
- How well is the child functioning at home and at school?
- Is the child able to eat regularly?
- What other health conditions are involved?
- Is the child at risk of being harmed by others?
- What medications is the child taking for other health conditions?
- Has the child had side effects from any medications?
- What kinds of treatment and medication are covered under your insurance plan?
Treatment options may include:
- Medications. Psychosis, anxiety, depression, and other symptoms may respond to medication.
- Education. Helping the child, family, and caregivers learn about schizophrenia can help.
- Psychotherapy. Individual, group, or family therapy may help.
- Cognitive behavioral therapy (CBT). CBT can help to improve thinking skills and lower distress from hallucinations
- Cognitive remediation therapy. One type of therapy, cognitive remediation therapy, may help boost attention, memory, and decision-making skills
- Life skills training. This type of training includes problem-solving, social skills, and job skills.
- Nutrition. Various diets may help improve symptoms and help maintain health in people with schizophrenia.
- Hospitalization. For some children, inpatient care may be an option.
Over time, treatments can change as symptoms stabilize and the needs of your child change.
Questions for my child’s mental health professional
- What other health conditions could be causing these symptoms?
- Does my child need a higher level of care?
- What are the risks and benefits of the medications prescribed for my child?
- What side effects should we expect with these medications?
- What changes should we make to our routines and behaviors as a family?
- How do I know when to seek emergency care for my child?
- What do I do if my child has a hallucination?
- What do we do if we think a dose is too high or too low?
- Which symptoms usually get better and which ones don’t?
- How will these medications affect my child’s ability to function in school?
- Should I share this with my child’s teachers and others, like their coaches? If so, how?
- What foods should we eliminate from my child’s diet?
Research shows that people with a first-degree family member – parents and siblings – with schizophrenia are
Some environmental conditions can also raise the risk, such as:
- exposure to marijuana during pregnancy
- malnutrition during pregnancy
- viral infections before birth
- fathers who are much older
- using psychoactive or mind-altering medications during the teen years
- an overactive immune system caused by systemic inflammation and other stress
No matter which risk factors are present in your child’s life, try not to blame yourself. Self-care and compassion will be important as you accompany your child on this journey.
Schizophrenia is a lifelong condition with symptoms that can be severe at times.
People with schizophrenia may have a higher risk of substance use disorders, depression, anxiety, suicidal thoughts and actions, and relationship challenges. A
If you’re concerned a child or teen may attempt suicide or harm themselves, stay with them. Take them to the nearest emergency room for immediate help.
Here are other ways to find help if you or a child or teen you know is considering suicide:
- Call the National Suicide Prevention Lifeline at 800-273-8255 (Ayuda En Español: 1-888-628-9454)
- En Español Red Nacional de Prevención del Suicidio at 1-888-628-9454.
- Contact the teen-to-teen peer hotline, Teen Line, at 800-852-8336 or text TEEN to 839863.
- For young People of Color, contact The Steve Fund text line (24/7) by texting STEVE to 741741.
- The Trevor Project provides crisis support for LGBTQIA+ people. Call their hotline at 866-488-7386 or text “START” to 678-678.
- Call a trusted mental health professional (therapist, counselor, or psychiatrist).
- Not in the United States? Find a helpline in your country with Befrienders Worldwide or the International Association for Suicide Prevention.
Childhood schizophrenia is rare, but when it does appear, symptoms are similar to those adults have. Your child may have hallucinations, delusions, fears that seem extreme, unusual speaking or movement habits, and changes in social relationships and academic performance.
It’s important to rule out other conditions that could be causing similar symptoms. Accurate diagnosis often requires meeting with different medical and mental health professionals. Your child’s treatment plan is likely to include medication, therapy, dietary changes, education, and skills training.
Early diagnosis and treatment are key. Even so, schizophrenia will be part of your child’s life throughout the teen and adult years. Schizophrenia is a serious condition. To manage the symptoms and work toward the best outcomes, you and your child will need to find sources of caring support.