Table of ContentsView AllTable of ContentsProfessional ScreeningsLabs and TestsDifferential DiagnosisSelf/At-Home Testing
Table of ContentsView All
View All
Table of Contents
Professional Screenings
Labs and Tests
Differential Diagnosis
Self/At-Home Testing
Childhood schizophrenia, also called childhood-onset schizophrenia (COS) or very early-onset schizophrenia, is a severe mental health disorder that is diagnosed in children under the age of 13. It is very rare, affecting less than 0.04% of children.
How Childhood Schizophrenia Is Diagnosed
Verywell / Brianna Gilmartin
Childhood schizophrenia is a difficult disorder to diagnose, partly because it is not well understood. The diagnosis requires the exclusion of other medical or mental health conditions that may have similar symptoms.
The gold standard for diagnosing childhood schizophrenia is using the American Psychiatric Association’s criteria in theDiagnostic and Statistical Manual of Mental Disorders(DSM-5).
When Does Schizophrenia Usually Develop?The symptoms of schizophrenia usually start in young adulthood, between late adolescence and the early 30s. Symptoms tend to emerge slightly sooner in men than in women.When the condition is diagnosed before the age of 18 but after age 13, it is referred to as early-onset schizophrenia (EOS). EOS is rare, with an estimated prevalence of 0.23%.
When Does Schizophrenia Usually Develop?
The symptoms of schizophrenia usually start in young adulthood, between late adolescence and the early 30s. Symptoms tend to emerge slightly sooner in men than in women.When the condition is diagnosed before the age of 18 but after age 13, it is referred to as early-onset schizophrenia (EOS). EOS is rare, with an estimated prevalence of 0.23%.
Schizophreniatypically develops slowly. The early warning signs usually start before the first severe episode (when hallucinations and delusions, called positive symptoms, are experienced for the first time).
If your child’s doctor thinks your child may have schizophrenia, they will send them to a mental health provider, who will conduct a psychiatric evaluation and other tests.
Mental Health Evaluation
During an evaluation, a mental health practitioner will observe your child’s appearance and demeanor. They will also ask your child about their thoughts, feelings, and behaviors, as well as get input from you about what you have observed. You will also discuss yourfamily’s medical history, particularly any mental health conditions.
A mental health professional will assess your child’s ability to think and function at an age-appropriate level, as well as their mood, anxiety level, and possible psychotic symptoms.
The diagnostic criteria that are used to diagnose childhood schizophrenia are similar to those that are used to diagnose adults with schizophrenia.
Positive and Negative Schizophrenia Symptoms
According to the DSM-5, a diagnosis of schizophrenia requires two or more of the following symptoms to be exhibited for a significant portion of time during a six-month period.
The DSM-5 criteria state that at least one of the symptoms must be delusions, hallucinations, or disorganized speech.
Other criteria for the diagnosis of schizophrenia in the DSM-5 include:
What Are the Different Types of Schizophrenia?
Ruling Out Other Conditions
The DSM-5 also requires a mental health practitioner to rule outschizoaffective disorderanddepressiveor bipolar disorder with psychotic features before making a diagnosis of schizophrenia.
If there is a history of autism spectrum disorder (ASD) or a communication disorder of childhood onset, schizophrenia can be diagnosed only if there are prominent delusions or hallucinations in addition to the other required symptoms of schizophrenia. These symptoms must have been present for at least one month (or less if the symptoms are successfully treated).
What Causes Schizophrenia?
Childhood-Onset vs. Adult-Onset Schizophrenia
People who develop schizophrenia at a young age might be more likely to experience certain symptoms compared with people who develop it later in life.
Children might also be less likely to experienceparanoid delusions(the belief that others are out to harm you) than people who develop schizophrenia at an older age.
A diagnosis of childhood schizophrenia requires the exclusion of other conditions. Certain tests can be performed to help make the correct diagnosis.
Is There a Schizophrenia Test?
Physical Examination
A physical exam helps clinicians rule out medical conditions that might explain a child’s symptoms. It also lets them assess the child for any health complications.
Imaging Studies
Differences in the brain structure and the central nervous system have been found to be associated with schizophrenia. Imaging studies to look for these changes and to rule out other neurological conditions might be performed.
Adifferential diagnosisis a crucial factor when diagnosing childhood schizophrenia. The presence of symptoms that are similar to those seen in other mental health conditions, the presence ofcomorbidconditions (where a child has more than one condition), and the early age at which children experience psychotic-like symptoms can all make it difficult to accurately diagnose childhood schizophrenia.
High rates ofcomorbidityhave been found in children with schizophrenia—specifically, attention deficit hyperactivity disorder (ADHD) and affective disorders.
Three disorders overlap with and can be difficult to distinguish from childhood schizophrenia:
There are also other more common mental health conditions that might be misdiagnosed as childhood schizophrenia:
Certain medical conditions can also be misdiagnosed as childhood schizophrenia:.
Behaviors in Healthy ChildrenSome of the symptoms of childhood schizophrenia appear in healthy children. For example, having a vivid imagination and fantasies are typical parts of childhood.However, they might be misunderstood to be hallucinations and taken as a symptom of schizophrenia.Similarly, children who have poor or underdeveloped language skills may be perceived as having the disorganized thought and speech patterns that are observed in schizophrenia.
Behaviors in Healthy Children
Some of the symptoms of childhood schizophrenia appear in healthy children. For example, having a vivid imagination and fantasies are typical parts of childhood.However, they might be misunderstood to be hallucinations and taken as a symptom of schizophrenia.Similarly, children who have poor or underdeveloped language skills may be perceived as having the disorganized thought and speech patterns that are observed in schizophrenia.
Some of the symptoms of childhood schizophrenia appear in healthy children. For example, having a vivid imagination and fantasies are typical parts of childhood.
However, they might be misunderstood to be hallucinations and taken as a symptom of schizophrenia.Similarly, children who have poor or underdeveloped language skills may be perceived as having the disorganized thought and speech patterns that are observed in schizophrenia.
Early Signs and Symptoms of Schizophrenia
Children often develop changes in behavior before the onset of schizophrenia.These changes in behavior are normally noticed when children start school at age 5 or 6. However, many families report that disruptive behavior began before their child started school.
These changes can manifest in a variety of different ways, including:
Behavioral difficulties can lead to children struggling in school—one of the most common issues reported in people diagnosed with schizophrenia at an early age.
The warning signs may start when a child is very young. People diagnosed with schizophrenia in childhood have more developmental difficulties than those diagnosed later in life.
Very early developmental warning signs include:
A Word From Verywell
Childhood schizophrenia is rare. Most behavioral changes or early warning signs associated with the condition will have other more common causes. However, if you are concerned about any behaviors or changes that your child is showing, it’s important to talk with their doctor.
Your child can be referred to a mental health provider for a careful evaluation and tests that will rule out other causes for their symptoms. If a diagnosis of schizophrenia is made, you will be able to ensure they get the treatment that is best suited to them.
Paranoid Personality Disorder Treatment
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Driver DI, Gogtay N, Rapoport JL.Childhood-onset schizophrenia and early-onset schizophrenia spectrum disorders.Child Adolesc Psychiatr Clin N Am. 2013;22(4):539-555. doi:10.1016/j.chc.2013.04.001National Institute of Mental Health.Schizophrenia. .Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health.Häfner H.From onset and prodromal stage to a life-long course of schizophrenia and its symptom dimensions: how sex, age, and other risk factors influence incidence and course of illness.Psychiatry Journal. 2019;2019:1-15. doi:10.1155/2019/9804836Bartlett J.Childhood-onset schizophrenia: what do we really know?.Health Psychology and Behavioral Medicine. 2014;2(1):735-747. doi:10.1080/21642850.2014.927738McClellan J, Stock S.Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(9):976-990. doi:10.1016/j.jaac.2012.02.008Parellada M, Gomez-Vallejo S, Burdeus M, et al.Developmental differences between schizophrenia and bipolar disorder.Schizophr Bull. 2017;43(6):1176-1189. doi:10.1093/schbul/sbx126
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Driver DI, Gogtay N, Rapoport JL.Childhood-onset schizophrenia and early-onset schizophrenia spectrum disorders.Child Adolesc Psychiatr Clin N Am. 2013;22(4):539-555. doi:10.1016/j.chc.2013.04.001National Institute of Mental Health.Schizophrenia. .Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health.Häfner H.From onset and prodromal stage to a life-long course of schizophrenia and its symptom dimensions: how sex, age, and other risk factors influence incidence and course of illness.Psychiatry Journal. 2019;2019:1-15. doi:10.1155/2019/9804836Bartlett J.Childhood-onset schizophrenia: what do we really know?.Health Psychology and Behavioral Medicine. 2014;2(1):735-747. doi:10.1080/21642850.2014.927738McClellan J, Stock S.Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(9):976-990. doi:10.1016/j.jaac.2012.02.008Parellada M, Gomez-Vallejo S, Burdeus M, et al.Developmental differences between schizophrenia and bipolar disorder.Schizophr Bull. 2017;43(6):1176-1189. doi:10.1093/schbul/sbx126
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Driver DI, Gogtay N, Rapoport JL.Childhood-onset schizophrenia and early-onset schizophrenia spectrum disorders.Child Adolesc Psychiatr Clin N Am. 2013;22(4):539-555. doi:10.1016/j.chc.2013.04.001National Institute of Mental Health.Schizophrenia. .Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health.Häfner H.From onset and prodromal stage to a life-long course of schizophrenia and its symptom dimensions: how sex, age, and other risk factors influence incidence and course of illness.Psychiatry Journal. 2019;2019:1-15. doi:10.1155/2019/9804836Bartlett J.Childhood-onset schizophrenia: what do we really know?.Health Psychology and Behavioral Medicine. 2014;2(1):735-747. doi:10.1080/21642850.2014.927738McClellan J, Stock S.Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(9):976-990. doi:10.1016/j.jaac.2012.02.008Parellada M, Gomez-Vallejo S, Burdeus M, et al.Developmental differences between schizophrenia and bipolar disorder.Schizophr Bull. 2017;43(6):1176-1189. doi:10.1093/schbul/sbx126
Driver DI, Gogtay N, Rapoport JL.Childhood-onset schizophrenia and early-onset schizophrenia spectrum disorders.Child Adolesc Psychiatr Clin N Am. 2013;22(4):539-555. doi:10.1016/j.chc.2013.04.001
National Institute of Mental Health.Schizophrenia. .
Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7
Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health.
Häfner H.From onset and prodromal stage to a life-long course of schizophrenia and its symptom dimensions: how sex, age, and other risk factors influence incidence and course of illness.Psychiatry Journal. 2019;2019:1-15. doi:10.1155/2019/9804836
Bartlett J.Childhood-onset schizophrenia: what do we really know?.Health Psychology and Behavioral Medicine. 2014;2(1):735-747. doi:10.1080/21642850.2014.927738
McClellan J, Stock S.Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(9):976-990. doi:10.1016/j.jaac.2012.02.008
Parellada M, Gomez-Vallejo S, Burdeus M, et al.Developmental differences between schizophrenia and bipolar disorder.Schizophr Bull. 2017;43(6):1176-1189. doi:10.1093/schbul/sbx126
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