How Does Schizophrenia Start?

Schizophrenia does not have one known cause. It is believed that genes and the environment both play a part. There is a 10 percent higher risk of developing schizophrenia if someone in the family (a parent, brother or sister) has the disorder.

Many scientists believe that the cause of schizophrenia is complicated and that factors in our environment such as viruses also are involved. Genes that we inherit from our parents along with the environment may interact to cause schizophrenia.

Who Has Schizophrenia?

Over one percent of the people in the United States have schizophrenia. Men and women are at equal risk of developing schizophrenia, and it can happen at any age.

Most people develop symptoms between the ages of 16 and 25 and this can occur suddenly, or there can be early signs of the disorder. Schizophrenia is rare in children under 12 and can be very hard to identify in the early phases. People do not usually develop symptoms past the age of 45.

Signs and Symptoms of Schizophrenia

There are three kinds of symptoms (negative, positive and cognitive). People with schizophrenia may have mostly one kind or a combination of symptoms.

Negative Symptoms

• Flat affect – when a person’s face does not show emotions when they speak
• Not being able to enjoy life
• Not wanting to be around other people
• Not being able to start or finish activities

Positive Symptoms

• Hallucinations – hearing or seeing things that are not there. Most common is hearing voices that talk to a person about their behavior or warn them of danger that isn’t real. This symptom is called “psychosis.”
• Delusions – beliefs that are not true and are often strange. They may believe that other people are trying to harm them.
• Strange thoughts that others notice because when they speak, they don’t make any sense, they jump from one topic to another, or they stop talking in the middle of a sentence for no reason.
• Body movements that are repeated over and over and the person might seem to be agitated

Cognitive Symptoms

• Having trouble using information to make decisions
• Poor attention and not able to focus
• Trouble with memory

Most Common Symptoms

The following are the most common symptoms of schizophrenia. If a child is at high risk for schizophrenia because of a known family history, you may look for early warning signs of schizophrenia that may include:

• Trouble telling dreams or television from reality
• Confused thinking
• Detailed and bizarre thoughts and ideas
• Fearfulness that someone, or something, is going to harm them or is “out to get them”
• Hallucinations (seeing, hearing, or feeling things that are not real such as hearing voices telling them to do something)
• Delusions (ideas that seem real but are not based in reality)
• Extreme mood swings
• Anxious or fearful when there is no danger
• Flat affect (no emotional expression when speaking)
• Trouble with schoolwork
• Social withdrawal (severe problems in making and keeping friends)
• Disorganized or catatonic behavior (suddenly becoming agitated and confused, or sitting and staring, as if immobilized)
• Odd behaviors (an older child may begin acting like a younger child)
• Poor personal hygiene (suddenly stops showering or caring about being clean)

Are People with Schizophrenia Violent?

Violence is not a symptom of schizophrenia. People with schizophrenia may become violent if they believe that someone is planning to harm them. Substance abuse may make symptoms of schizophrenia worse and may increase the likelihood of violence. Substance abuse may also make treatment less effective, and a person with a substance abuse problem may be less likely to seek treatment.

How Is Schizophrenia Diagnosed?

Children with schizophrenia behave differently from adults with schizophrenia and do not usually experience delusions or show cognitive symptoms until the late teen years. The symptoms of schizophrenia may look like other problems or psychiatric conditions. Always consult your child's physician for a diagnosis.

Schizophrenia in children and teens is usually diagnosed by a child and teen psychiatrist. Other mental health professionals usually participate in the completion of a comprehensive mental health evaluation to determine individualized treatment needs.

Treatment for Schizophrenia

Your child’s doctor will make a plan for your child based on the following:

• Overall health and medical history
• The kind of symptoms your child is showing and how severe they are
• What medicines, procedures or therapies that your child can tolerate

Schizophrenia is a major psychiatric illness. Treatment for schizophrenia is complex. A combination of therapies is often necessary to meet the individualized needs of the child or teen with schizophrenia.

There is currently no cure for schizophrenia. Treatment is aimed at reducing the symptoms linked with the disorder. When symptoms are particularly bad, a child with schizophrenia may need to be hospitalized. Types of treatment that may be helpful to a child or teen with schizophrenia may include:

• Antipsychotic medicines. This type of medicine can be helpful for many of the symptoms listed above. Some examples of traditional antipsychotic medicines include haloperidol (Haldol), chlorpromazine (Thorazine) and fluphenazine (Prolixin). Newer antipsychotic medications, called atypical antipsychotics, include risperidone (Risperdal), olanzapine (Zyprexa), ziprasidone (Geodon), aripiprazole (Abilify) and quetiapine (Seroquel). The most common side effect that children report with the newer antipsychotic medicine is weight gain. Children taking these medicines are monitored for insulin resistance, which could lead to the development of diabetes.
• Individual and family psychotherapy. Individual therapy may focus on developing social skills. Family therapy may help family members cope with the child's illness.
• Specialized educational or structured activity programs social skills training, vocational training, speech and language therapy, smaller classroom size, modification of academic work

Preventive Action for Schizophrenia

No one knows how to prevent schizophrenia currently. The best we can do is to notice early signs and symptoms for a correct diagnosis. If treatment can start when symptoms are mild, it can help improve the quality of life for children and teens with schizophrenia.

Treatment is most successful when symptoms of the first psychotic episode are addressed quickly and properly. Studies suggest that early treatment may keep the illness from getting worse and help reduce some of the long-term effects of schizophrenia.

It is important to the success of the treated child or teen who is prescribed medicines for the treatment of schizophrenia to keep taking the medicine as prescribed. Dosages and types of medicines may need to be adjusted from time to time to stay effective. Always consult your child's physician for more information.

For More Information

For additional information on this topic, visit the National Institute of Mental Health website.