Childhood Schizophrenia: Causes and Management of This Mental Disorder Research Paper

Introduction

Background Information

Judd (2009) tells the story of a seven-year-old girl named Jani Schofield. When producers of Oprah Winfrey show lived with Jani’s family for one week, they realized just how hard the parents were struggling to bring her up together with her younger brother Bodhi. The parents told the producers how their daughter slips into ‘psychotic moments’ as a result of apparently harmless triggers such as calling her by her full name ‘January’.

During such moments, the girl will instantly change from a sweet little angel to a shrieking and violent little girl. Michael and Susan Schofield narrate to the producers how they were forced to separate their two children to reduce the likelihood of the girl injuring the little boy during such moments. The children will spend the days together, but during the night, they will be boarded into different apartments each accompanied by one parent.

Jani’s life is unlike that of any other seven-year-old girl. The parents narrate to the producers how their little daughter experiences many hallucinations and how she hears strange voices in her head. At times she will stare at one spot for a long time claiming to see things that are not visible to other people around her.

Jani Schofield suffers from childhood schizophrenia. She is among the less than 1 in 30000 children under the age of eleven years who are diagnosed with the condition in the United States of America every year (Bender, 2010).

The symptoms of this condition are not unlike those among adults suffering from the same condition. According to Maatai et al. (2011), approximately 1 percent of Americans suffer from this condition. They report hallucinations accompanied by irrational thoughts and at times, violent behavior like that reported in Jani above.

Problem Statement

Seese et al. (2010) define schizophrenia as a form of a mental disorder that is accompanied by breaking down of thought processes in the individual as well as other emotional disorders such as violence, extreme fear or withdrawal. Many patients suffering from this condition report incidences of auditory and visual hallucinations.

Their speech and thinking processes are also disintegrated as indicated above. The patient also suffers from social and occupational dysfunctions as a result of their condition (Seese et al., 2010). This means that their social and occupational life is impaired as a result of the effects of the mental condition.

Maatai et al. (2011) are of the view that most of the symptoms associated with schizophrenia appear during young adulthood. This is from the age of 12 and in some instances, even before. According to Bender (2010), about 0.3 to 0.7 percent of the world population suffers from schizophrenia. The condition can be diagnosed from behavioral observations made on the individual as well as from the experiences that are reported by the patient.

The exact cause of this mental disorder is not well known. However, experts in this field are of the view that a combination of several factors may be the possible cause of the condition. This includes factors such as genetics, the social and psychological environment within which the individual is brought up as well as some other factors touching on the patient’s lifestyle such as abuse of drugs among others (Hardman, Drew & Egan, 2011).

According to Maatai et al. (2011), childhood schizophrenia can also be regarded as early schizophrenia given the fact that it manifests itself during the early years of the patient’s life. As indicated above, the symptoms accompanying childhood schizophrenia are largely similar to those in adult schizophrenia, the only difference been the age of the patient.

Schizophrenia occurring during the first 11 years of life is generally referred to as childhood schizophrenia although the age limit varies from one specialist to the other. On the other hand, schizophrenia occurring between 11 years and 18 years can be regarded as young adulthood or youth schizophrenia (Judd, 2009).

Childhood schizophrenia is a topic that has attracted the interest of experts in youth affairs. This is given the fact that the condition has far reaching effects on the social and occupational life of the youth suffering from it. It is against this backdrop that this author is going to write this research paper.

The research paper is going to address several issues surrounding childhood schizophrenia. The author is going to look at the probable causes of the condition, the effects it has on the child or young adult suffering from it, strategies to manage the condition among other issues.

Causes of Childhood Schizophrenia

As earlier indicated in this research paper, the exact cause of schizophrenia is not well known. However, experts agree that the probable causes of the condition among children are largely similar to the causes among adults. Another aspect of childhood schizophrenia that is little understood is why it develops early in life in some individuals while in others in develops later in life (Seese et al., 2010).

A combination of biological and social factors is thought to be the major cause of childhood schizophrenia. This means that the child might inherit some schizophrenic genes from both or either of the parents and combine this with the social environment within which they are brought up. It also means that the schizophrenic genes may remain dormant in the child if the social environment within which the child is brought up is not conducive for their manifestation (Bender, 2010).

Disruption of brain development in the child has been shown to arise from, among other factors, genetic disruptions and environmental stressors (Hardman et al., 2011). The genetic disruptions and environmental stressors can take place during pregnancy or early childhood, affecting the development of the child’s brain in that particular stage and later in life. The brain alterations arising from these factors may be subtle and in some cases negligible. However, they increase the likelihood of the child developing schizophrenia early in life.

The environment to which the child is later exposed after birth interacts with the brain alterations to either increase or reduce the likelihood of the child developing schizophrenia. For example, the environmental factors may further damage the brain of the child increasing their likelihood to develop the condition (Bender, 2010). Alternatively, the environmental factors can suppress the effects of genetic defects and brain alterations reducing the risk of the child developing the condition.

This probable interplay of factors has made experts in this field believe that schizophrenia and other mental conditions are not caused by a single factor but a combination of several factors. These include biological and socio-psychological factors. This has led to the development of a bio-psycho-social model to explain the cause of mental illnesses such as schizophrenia. The figure below vividly illustrates this model:

Figure 1: Bio-psycho-social Model

Source: Judd (2009)

The figure above illustrates how a combination of biological, genetic and early childhood environmental factors combines to cause childhood schizophrenia. Environmental factors in this case may include presence or absence of social stressors, drug use, childhood isolation among others (Harman et al., 2011). All these factors may trigger the onset of this condition in the child.

Studies conducted in this field further support the role that genetics play in childhood schizophrenia. Hardman et al. (2011) are of the view that the risk of a child suffering from this condition is one percent when there are no recorded cases of the condition in the family. However, this rises to about ten percent if a first degree member of the child’s family has suffered from the condition before. The risk further rises to fifty percent if an identical twin suffers from childhood schizophrenia (Hardman et al., 2011).

Other environmental factors that might increase the likelihood of the child developing schizophrenia (apart from the ones listed above) include maternal infections such as viral infections and influenza during pregnancy. Others are oxygen deprivation during birth and other untreated conditions on the part of the mother.

Misconceptions and Myths Surrounding Childhood Schizophrenia

Childhood schizophrenia has been poorly understood by many people in the society. This has led to the development of many myths and misconceptions surrounding this condition. According to Seese et al. (2010), it is important to fully understand this condition before helping the children suffering from it and their families. The first step towards this understanding involves debunking the various misconceptions and myths surrounding the condition. Following are some of the myths and misconceptions about childhood schizophrenia:

Childhood Schizophrenia is Split Personality

According to Judd (2009), this is one of the most common misconceptions about this condition. She argues that schizophrenia is not split personality. According to Maatai et al. (2011), the latter is a totally different mental condition that is less common than the former. Additionally, children suffering from schizophrenia cannot be described as having a split personality. To the contrary, they can only be described as being ‘split off’ from reality (Hardman et al., 2011).

Childhood Schizophrenia is a Rare Mental Disorder

This condition is not as rare as most people like to believe. According to Hardman et al. (2011), one out of every 100 children in the world is at risk of developing schizophrenia. In the United States of America, 1 child out of every 30000 children is believed to be suffering from this condition. These facts debunk the misconception that child schizophrenia is a rare condition.

Children with Schizophrenia are Beyond Help

This is another myth that has made it hard for children living with schizophrenia to receive specialized care either at home or in a hospital. It is a fact beyond doubt that some cases of childhood schizophrenia may call for lifetime medication to manage them (Judd, 2009). However, it is not accurate to claim that these children cannot be helped. If the condition is well managed, the child is able to lead a relatively normal life just like any other child their age.

Children Suffering from Schizophrenia are Dangerous

It is a fact beyond doubt that children with schizophrenia tend to be more violent and boisterous than other children their age. This is as a result of the delusions and hallucinations that these children experience. However, to claim that these children are dangerous than their counterparts who are normal is erroneous. The fact is that the children are not any more violent than the average child or a danger to other people around them (Hardman et al., 2011).

Types of Childhood Schizophrenia

There are several forms of schizophrenia that are visible among children. Maatai et al. (2011) is of the view that forms of schizophrenia among children are similar to those among adults. Three major forms of this condition have been recorded to date. Different major symptoms are used to classify schizophrenia into several forms. The three major forms of this condition are as analyzed below:

Catatonic Schizophrenia

This form of childhood schizophrenia affects the child’s motor activities. According to Seese et al. (2010), a child suffering from this form of schizophrenia exhibits either a decrease or an increase in motor activity. The latter is referred to as an excited state while the former is stuporous state (Seese et al., 2010). A decrease in motor activity brings to a halt almost all voluntary movements and speech in the child. In some cases, the child may stay in one position for hours, resisting any change of position even when they are tired.

Bender (2010) notes that a child suffering from this form of schizophrenia may suddenly pass from stuporous to excited state. When this happens, the child may exhibit violent behavior such as shouting, speaking fast and pacing back and forth (Bender, 2010). This violent behavior may be directed towards the self or towards other people around them. This is the reason why Jani Schofield (refer to the introduction part of this paper) was being isolated by her parents.

Paranoid Child Schizophrenia

This is perhaps the most common form of schizophrenia among adults and possibly so among children. The child expresses crazy and outrageous ideas and beliefs. Hardman et al. (2011) note that the ideas and beliefs of such a child are formed around coherent and fairly well organized themes. The story given by the child in such situations remains constant and unchanging over time.

A child suffering from this form of schizophrenia experiences difficulties with their social relationships. This is given the fact that they view other people around them with a lot of suspicion. However, it is noted that children suffering from this form of schizophrenia are better off than their counterparts suffering from disorganized and catatonic schizophrenia.

This is given that their thinking processes are less disintegrated as compared to those in the other two categories. It is also noted that their long term prognosis is much better than that of those suffering from the other two conditions.

Disorganized Child Schizophrenia

This is the third form of schizophrenia that is reported among both children and adults. According to Maatai et al. (2011), the symptoms of this form of schizophrenia appear much earlier than those of other forms of the condition. This form of child schizophrenia also develops gradually unlike the other two forms which may appear abruptly.

As the name suggests, this form of child schizophrenia is characterized by disorganized thinking processes and other impaired functions (Maatai et al., 2011). This may include disintegrated speech, disintegrated behavior and disorganized emotions on the part of the child. It is also noted that children suffering from this form of schizophrenia are unable to take care of themselves most of the time. They may be unable to feed or clean themselves, relying on the help of their parents and other people around them.

Like those suffering from paranoid schizophrenia, children with disorganized schizophrenia may experience visual and audio hallucinations and delusions (Maatai et al., 2011). However, the fantasies experienced by these children are not as consistent or as organized as those experienced by those suffering from paranoid schizophrenia (Bender, 2010).

Effects of Childhood Schizophrenia

Having looked at the causes of schizophrenia and the various forms of this condition among children, it is now important to look at the effects that the condition has both on the child suffering from it and on other people around them such as family members. Understanding the effects of this condition is one of the ways through which the society can appreciate the significance of the condition among children and young adults. The following are some of the effects of childhood schizophrenia:

Increased Suicidal Tendencies

Seese et al. (2010) notes that children with schizophrenia report more incidences of attempted suicide than other children their age. As a result of this, experts in this field advice parents and other people who are in contact with these children to take seriously any suicidal talks or threats that are expressed by the child (Seese et al., 2010).

It is during psychotic moments that the child is more likely to attempt committing suicide. As such, it is noted that it is important for the child to be put under constant observation at such moments. Those patients who are suffering from depression as a result of schizophrenia are at high risk of attempting suicide if the parents or other people around them do not intervene.

It is also noted that the first six months after the patient is put under medication are critical as far as attempted suicide is concerned. This is given the fact that this is the period that the child is more likely to try and take away their own life (Seese et al., 2010).

Abuse of Drugs

Bender (2010) notes that abuse of drugs and alcohol is frequently reported among adults suffering from this condition. Initially, the individuals use the drugs and alcohol to try and manage their condition before they consult a doctor. The drugs are abused as the patients become addicted to them. Abuse of drugs hampers the management of this condition through medication. This is given that alcohol and other drugs interfere with the effects of medications on the patient.

Children and young adults are also at risk of abusing drugs and alcohol as a result of their schizophrenic conditions. This is for example when they become addicted to morphine and other drugs that are used to manage their condition.

Social Dysfunction

The child may suffer from social dysfunctions as a result of their condition. The child may be unable to effectively interact with other children and other people around them. For example, the child may withdraw and fail to interact with other people when they are depressed (Bender, 2010).

Other people may also avoid the company of the child for fear of outbursts of violent behavior. It was earlier mentioned in this paper that paranoia is a major symptom among children suffering from schizophrenia. This paranoia may make it hard for them to interact with others. This is given the fact that the schizophrenic child will be suspicious of other children and other people around them (Hardman et al., 2011).

Occupational Impairment

Adults suffering from schizophrenia experience major disruptions when it comes to their day-to-day activities such as family and work. This may be as a result of the inability to interact with their colleagues as a result of social dysfunctions brought about by their condition. It may also be as a result of impaired motor functions as a result of schizophrenia making it hard for them to carry out daily activities such as bathing and eating.

The case is no different when it comes to childhood schizophrenia. Children suffering from this condition may find it hard to carry out simple tasks such as bathing, eating, walking and such others (Hardman et al., 2011). This is given the fact that like their adult counterparts, they are unable to interact socially with other people around them to carry out the tasks.

Is Childhood Schizophrenia Preventable?

Some conditions and diseases are easier to prevent than others. Conditions and diseases that have reliable markers indicating later development of the condition are easier to prevent since intervention measures can be put into place as soon as the markers are identified. For example, conditions such as polio are easily prevented through a vaccine while others can be prevented by changing the lifestyle of the individual.

However, it is not possible to prevent childhood schizophrenia. Hardman et al. (2011) note that early intervention as far as childhood schizophrenia is concerned is effective only during psychotic episodes. This form of intervention has short term benefits only on the part of the child.

This is given the fact that after five years of living with the condition, a child will benefit less from such an intervention (Maatai et al., 2011). Preventive measures during prodome stage of this disease are especially ineffective. As such, it can be concluded that childhood schizophrenia is not easily preventable.

Managing Childhood Schizophrenia

Seese et al. (2010) note that antipsychotic medications are the primary form of treatment for this condition among children. The medications are combined with other interventions such as psycho-social support for the child. It is noted that some severe forms of childhood schizophrenia calls for hospitalization especially in mental institutions.

However, it is important to note that hospitalization is a short term measure given the deinstitutionalization policy that begun in the mid 20^th century in the United States of America (Seese et al., 2010).

The most common schizophrenic management techniques include community support service for the child and their family (Judd, 2009). This involves home visits made by social workers as well as other forms of support given for example through education. It is noted that regular exercise on the part of the child can be used to improve their mental and physical health, effectively managing the condition.

Managing Childhood Schizophrenia through Medication

As already indicated in this paper, medication is the common form of management for this condition among children. It is noted that antipsychotic medication can mitigate the negative impacts of psychosis among children in a span of about 1 or 2 weeks. However, it is important to note at this juncture that medication is not effective in managing the cognitive dysfunction that is associated with childhood schizophrenia.

There are various types of antipsychotic drugs that can be used to manage schizophrenia among adult patients. These include Risperidone, Clozapine among others. In the process of deciding which drug to use in managing schizophrenia, the patient together with their doctor must take into consideration several factors.

These include the benefits of the proposed form of medication, the risks associated with the drug as well as the costs that are to be incurred (Bender, 2010). The same applies to childhood schizophrenia. Several medication options are available and a choice has to be made among them to effectively manage the condition.

Managing Childhood Schizophrenia through Psychosocial Support

Like in the case of medications, there are several forms of psychosocial interventions used in managing childhood schizophrenia. Maatai et al. (2011) give the example of family therapy where the psychosocial support focuses on the whole family as opposed to focusing only on the patient. The family members may undergo guidance and counseling to help them cope with the child suffering from schizophrenia. The members of the family may also be instructed on how to support the child socially and otherwise.

Other forms of psychosocial intervention include cognitive behavioral therapy (herein referred to as CBT) which focuses mainly on the child and significant others. However, Bender (2010) notes that the effects of this technique when it comes to mitigating the negative effects of childhood schizophrenia and averting relapse are minimal. As such, the technique is not as popular as family therapy.

Significance of Childhood Schizophrenia

It is noted that the impacts that this mental condition has both on the child and on the society as a whole cannot be ignored. The impacts range from economic costs resulting from the money spent on medication and therapy as well as human costs incurred through social interactions with the child.

The life expectancy of a person living with this mental condition is reduced by about 14 years (Bender, 2010). This is given the fact that the condition is usually accompanied by other life threatening conditions such as obesity and suicidal tendencies. It is also noted that childhood schizophrenia may also lead to disability.

Bender (2010) notes that about 75 percent of patients suffering from this condition experience ongoing disability with relapses. However, it is important to note here that most children suffering with this condition are able to lead relatively normal lives. This is especially so if they receive adequate medical and moral support.

Conclusion

This research paper looked at various issues surrounding childhood schizophrenia. The author looked at the probable causes of the condition, types of schizophrenia and the effects that the condition has both on the individual and on the community within which they live. Other issues covered include management of childhood schizophrenia and significance of this condition in the society. This research paper found that there is no single known cause of childhood schizophrenia.

However, a combination of genetic and environmental factors has been seen to increase the risk of a child suffering from this condition. The significance of this condition in the community cannot be downplayed. This is given the fact that it greatly affects the life of the child and their potential in the society. This is another issue that was addressed by the author in this paper.

References

Bender, L. (2010). Child schizophrenia: Clinical study of one hundred schizophrenic children. American Journal of Orthopsychiatry, 17(1), 40-56.

Hardman, M. L., Drew, C. J., & Egan, M. W. (2011). Human exceptionality: School, community, and family. New York: Free Press.

Judd, A. (2009). Jani Schofield: Childhood schizophrenia, living with the illness. Web.

Maatai, A., et al. (2011). Normalization of cortical gray matter deficits in nonpsychotic siblings of patients with childhood-onset schizophrenia. Journal of the American Academy of Child & Adolescent Psychiatry, 50(7), 698-704.

Seese, R., et al. (2010). Proton magnetic resonance spectroscopy and thought disorder in childhood schizophrenia. Journal of Nervous and Mental Disease, 22(5), 156-172.