Childhood-Onset Schizophrenia:
An Update from the National Institute of Mental Health

A child's stage of development must be taken into account when considering a diagnosis of mental illness. Behaviors that are normal at one age, may not be at another. Rarely, a normal young child may report strange experiences - such as hearing voices - that would be considered abnormal at a later age. Clinicians look for a more persistent pattern of such behaviors. Parents may have reason for concern if a child of 7 years or older often hears voices saying derogatory things about him or her, or voices conversing with one another, talks to himself or herself, stares at scary things - snakes, spiders, shadows - that aren't really there, and shows no interest in friendships. Such behaviors could be signs of schizophrenia in children, a chronic and disabling form of mental illness.

Fortunately, schizophrenia is rare in children, affecting only about 1 in 40,000, compared to 1 in 100 in adults. The average age of onset is 18 in men and 25 in women. Ranking among the top 10 causes of disability in developed countries worldwide, schizophrenia, at any age, exacts a heavy toll on patients and their families. Children with schizophrenia experience difficulty in managing everyday life. They share with their adult counterparts hallucinations, delusions, social withdrawal, flattened emotions, increased risk of suicide and loss of social and personal care skills. They may also share some symptoms with - and be mistaken for - children who suffer from autism or other pervasive developmental disabilities, which affect about 1 in 500 children. Although they tend to be harder to treat and have a worse prognosis than adult-onset schizophrenia patients, researchers are finding that many children with schizophrenia can be helped by the new generation of anti-psychotic medications.

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