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  • Dr HariOm Vaja

Childhood Psychosis



How do you define psychosis?


● Psychosis is a severe mental condition where an individual experiences difficulty in social interaction, recognizing reality, and managing the tasks of daily life. The condition is marked by symptoms such as paranoia, delusions regarding one's identity or surroundings, and sensory experiences of sights, sounds, or sensations that are not real [1].


● Psychosis is a serious mental illness. Due to poor cognitive and emotional control, children with the condition tend to get detached from reality, which can drastically obstruct how they see their environment and the social lives of others around them. Furthermore, since children are usually the center of attention in a family, this can create a burden (due to the additional need for attention and support), leading to the development of anxiety and other challenges for the parents/guardians.


● Schizophrenia is the most pervasive and debilitating mental disorder and represents the most prevalent type of psychosis among all mental illnesses. Early-onset schizophrenia, often known as childhood schizophrenia, can affect people under the age of 13. This rare disorder is believed to impact only a small proportion of children [2]. Although the severity of the impairment is frequently greater in children, the symptoms of childhood-onset schizophrenia are typically the same as adult-onset schizophrenia. Additionally, these symptoms can have a sizable impact on how a child behaves and develops [3].


What warning signals should you watch for?


● When it comes to schizophrenia in children, the symptoms can differ depending on their age. For instance, kiddos with juvenile schizophrenia may experience trouble with their language development, and motor skills such as walking and crawling later than usual, or unusual body movements like rocking or flapping of their arms. These can be some of the first signs of schizophrenia in kids [2]. (Note: Some of these symptoms are also seen in children with developmental disorders such as autism. As a result, screening for developmental issues is one of the first steps in diagnosing psychosis.


● Spotting schizophrenia symptoms in teenagers can be tricky. The reason is that some of these signs may overlap with normal adolescent behaviors. So, keep an eye out for things like withdrawing from family and friends, falling grades, sleep troubles, crankiness or feeling down, losing interest in things, odd behavior, or getting into substance abuse. Interestingly, unlike adults, teens with schizophrenia are less likely to have delusions and more likely to have visual hallucinations [2].


● As young folks with schizophrenia start to hit their teenage years, they may start showing classic signs of the condition. These might include:


-Delusions: These are erroneous beliefs that aren't supported by evidence as they lack a basis in reality, and most individuals with schizophrenia have them.

- Hallucinations: These can involve perceiving sights or sounds that aren't really there. Among them, auditory hallucinations, such as hearing voices are the most prevalent.

-Disorganized thinking: This can make it difficult for them to communicate effectively, leading to responses that may be partially or completely irrelevant to the question.

- Disorganized or abnormal motor behavior: This might include disregard for directions, total unresponsiveness, improper or strange bodily postures, or purposeless and exaggerated movements.

- Negative symptoms: This refers to a diminished capacity or absence of capacity to carry out regular tasks on a daily basis. For example, they may disregard personal hygiene or appear apathetic. Moreover, they may also lose interest in activities they used to previously enjoy, withdraw socially, or lose their ability to feel pleasure.

Remember, a trained professional is needed to make the diagnosis, so don't rely on your own suspicions or acts of labeling someone with disease-related words!


What causes childhood psychosis?

● Now, the exact causes of most psychiatric disorders are still kind of a mystery. However, we do know that their development can be influenced by a variety of factors - some you're born with (congenital), some are in your environment, and some are related to your mind and emotions (psychological). It's a complex puzzle, but we're working hard to figure it out!


What are the risk factors contributing to childhood psychosis?

●Brain anatomy: Some people develop too few or too many connections between neurons.

●Having a family history of schizophrenia or other personality disorders.

●Age: Father older than 30 years of age at the time of conception [4].

Genetics. Some people have changes to their genes (mutations). These changes can be inherited (passed down through families) or happen on their own.


How is childhood schizophrenia diagnosed?

●Diagnosing schizophrenia in children can be tough. This is because some healthy kids may also experience hallucinations or delusions, which can make it challenging to distinguish between normal and abnormal behavior. For example, it's common for kids to have imaginary friends as part of their normal development. However, if you notice any concerning signs, like unusual behavior or changes in their relationships, it's important to pay attention and keep an eye out for other symptoms. Being aware and understanding of the potential signs can help you recognize when to seek help or support from a mental health professional. Other mental health conditions like attention deficit hyperactivity disorder (ADHD), major depressive disorder, bipolar disorder, and schizoaffective disorder can have similar signs and symptoms as well. So, it's crucial to work with a mental health professional to get the right diagnosis and treatment plan.

●Diagnosing schizophrenia in children is not a one-step process. There is no single test that can confirm if a child has schizophrenia. A doctor needs to rule out other medical conditions, developmental disorders, or drug-related issues that may cause similar symptoms. Plus, they need to consider other psychiatric illnesses that could have similar signs. That is why, it is crucial to seek the help of a mental health professional if you notice any concerning behaviors or changes in your child's well-being. They can assess what's going on and determine the best course of action to support your child's mental health.

● Doctors diagnose childhood schizophrenia with a combination of mental and physical tests. To check for physical causes, a doctor may use:

- Magnetic resonance imaging (MRI): This test uses radio waves and strong magnetic fields to help doctors see whether there are any abnormalities in the brain.

- Positron emission tomography (PET) and single photon emission computed tomography (SPECT): A radioactive chemical called a tracer is injected into the bloodstream to allow the doctor to see blood flow in the brain [2].


What is the treatment of childhood psychosis?


●The treatment of childhood psychosis involves managing symptoms and improving overall well-being. There are different ways to do this, such as taking medication, going to therapy, or a mix of both. Antipsychotic medications can help ease symptoms like hallucinations, delusions, and other kinds of psychosis. Therapy options such as cognitive behavioral therapy (CBT) or family therapy can also help with managing symptoms and developing social and communication skills. The most important thing is to work with a mental health professional (A psychiatrist, duh!) to come up with the right treatment plan for your child. By doing so, you can make sure they receive the care and support they need to manage their symptoms and enjoy a better quality of life.


What we can do to help?

●Childhood psychosis can be tough for both the child and their family. Here are a few things you can do to help:


- Educate yourself: Learning about childhood psychosis and its symptoms can help you better understand what your loved one is going through. It can also help you recognize early warning signs, seek help promptly, and develop strategies for coping.


- Get support: It's essential to build a network of support for both the child and their family. Support groups or therapy can provide a safe space to share feelings, learn coping skills, and connect with others going through similar experiences.


- Encourage treatment: Encouraging and supporting the child to get a proper diagnosis and seek treatment from a certified specialist is crucial. Make sure they attend all appointments and take their medication as prescribed. It's also important to provide a supportive environment for them to communicate and express themselves.


- Practice self-care: Caring for a loved one with childhood psychosis can be emotionally draining, so taking care of your own mental health is critical. Make sure to take breaks when needed, maintain a healthy lifestyle, and seek professional help if necessary.


Remember, coping with childhood psychosis is not easy, but with the right support and care, the patient and their family can manage the condition and live a fulfilling life.


Bibliography

1. Definition of psychosis. (2011, February 2). Www.cancer.gov. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/psychosis


2. Childhood Schizophrenia: Causes, Symptoms, Diagnosis & Treatment. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21067-childhood-schizophrenia#:~:text=is%20childhood%20schizophrenia%3F-.


3. Psychosis. (n.d.). Www.nationwidechildrens.org. Retrieved February 7, 2023, from https://www.nationwidechildrens.org/conditions/psychosis#:~:text=pains%20of%20adolescence.-


4. Lan, K. C., Chiang, H. J., Huang, T. L., Chiou, Y. J., Hsu, T. Y., Ou, Y. C., & Yang, Y. H. (2021). Association between paternal age and risk of schizophrenia: a nationwide population-based study. Journal of assisted reproduction and genetics, 38(1), 85–93. https://doi.org/10.1007/s10815-020-01936-x





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