Teens Schizophrenia: Symptoms, Causes, Diagnosis & Treatment

Schizophrenia in teens is a chronic mental condition that affects a person’s brain, making it difficult to differentiate between reality and fantasy. People with schizophrenia are typically ignorant of reality, a condition called psychosis, and are thus, delusional (1). Several factors, including physical, emotional, and environmental factors, can impact teens’ mental health and well-being. This can further make them vulnerable to behavioral, emotional, and neurological disorders such as depression, psychotic, and anxiety disorders.

Read this post to know the causes, symptoms, treatment, and management options for schizophrenia.

Can A Teenager Have Schizophrenia?

Although schizophrenia is rare in childhood, its incidence is reportedly high in adolescence. Approximately 0.23% of children between 13 and 18 years have this condition (2).

What Are The Signs And Symptoms Of Schizophrenia In Teens?

Identifying schizophrenia in teens can be difficult as the onset of symptoms is insidious and not easily recognizable. The symptoms may start suddenly or gradually over a period, also referred to as the prodromal period (3). During this phase, the teenager may exhibit changes in their behavior, thought process, eating and sleeping patterns, and a decline in academic performance.

The symptoms of schizophrenia are broadly categorized into positive and negative ones (4).

Positive symptoms

The positive symptoms are those changes or inclusions in a person’s behavior that start appearing before a first schizophrenic episode. These include

• Hallucinations: These usually include hearing voices and seeing and smelling things that other individuals cannot perceive. Hallucinations can have a strong and realistic impact on the teen experiencing them.

• Delusions: These refer to false beliefs held by the teen based on unrealistic views and can hamper their ability to believe in real facts.

• Thought disorders: Some teens might find it challenging to keep track of their thoughts and conversations. They may also have trouble concentrating or thinking sanely, and their speech may be difficult for other people to understand.

• Behavioral changes: These changes are unpredictable, and the teen may start to be disorganized and forgetful. They may also feel that someone is controlling their thoughts and body movements.

Negative symptoms

Negative symptoms manifest in the form of a defect and cause a delay or lack of typical characteristics in the individual. These may include

• Lack of emotional connection when conversing with someone
• Frequent mood swings.
• Antisocial behavior and loss of interest in friends and relationships.
• Difficulty in concentrating and focusing on academic activities.
• Changes in eating and sleeping patterns and not wanting to go outdoors.
• Not caring about their appearance and personal hygiene.
• Lack of motivation or interest in games and routine activities.
• Uncomfortable around people, disinterest in talking to people, and avoiding any conversations.

These symptoms of schizophrenia in a teen might be mistaken for rudeness, laziness, and even depression (5). Therefore, it is of utmost importance to look for these psychotic signs in your child and contact a healthcare provider if you find changes in their behavior.

What Are The Causes Of Teenage Schizophrenia?

The exact cause of this condition is not known. However, it is believed to be a combination of physical, psychological, hereditary factors, physiological (chemical imbalances caused in the brain), and environmental factors.

• Genetic modifications, including deletions and duplications in chromosomes, primarily the deletion of 22q11, a region of chromosome 22, can alter multiple genes and their functions and lead to the development of schizophrenia (6) (7).

• Researchers also believe that an imbalance in brain chemicals (neurotransmitters), namely dopamine, glutamate, and serotonin, is the primary causative factor of this condition, as these neurotransmitters are vital in controlling how a person’s brain reacts to any stimulus. This phenomenon also explains why a teen with schizophrenia cannot process essential sensory stimuli, such as sounds, sights, and smells, and have hallucinations and delusions (8). 

What Are The Risk Factors For Schizophrenia?

The following factors are believed to increase a teen’s risk for schizophrenia.

1. Familial history of schizophrenic disorders or personality disorders: Evidence suggests that a person is significantly at a higher risk of developing schizophrenia if they have a parent, sibling, or a close relative with the disorder (9).

2. Pregnancy and post-pregnancy complications. Children who have experienced birth-related complications such as low birth weight, premature birth, and malnutrition are more likely to develop schizophrenia than others (3).

3. Environmental factors: Physical, sexual, or emotional abuse, stress, head injury, exposure to viruses, and an overactive immune system or auto-immune disorders are also known triggers for schizophrenia (3)(10).

4. Substance use: Intake of drugs, especially the use of psychoactive drugs such as cannabis, can increase the child’s risk by two-fold (3) (11).

What Are The Possible Complications Of Schizophrenia?

Schizophrenia can make a teen’s life quite challenging. Some complications of schizophrenia include (12)

• Thoughts of injuring self.
• Suicidal tendencies.
• Social stigma and discrimination.
• Higher risk of developing other mental illnesses, such as depression, anxiety disorders, OCD, and bipolar disorder.
• Physical illnesses, such as cardiovascular, metabolic, and infectious diseases.
• Inability to live alone, attend school, learn, memorize, or focus on things.
• Alcohol or drug addiction, further leading to other medical problems.
• Behavioral and emotional problems, family problems, social isolation, and homelessness.

When To Call A Doctor?

Consult a medical practitioner immediately if you notice any of the following warning signs in your teen.

• Sudden bouts of depression, anxiety, fear, and social disconnect
• Drastic changes in their routines and sleeping and eating patterns
• Uncontrollable emotions
• Hearing and seeing things that no one else can
• Refusal to take medicines
• Side effects to medicines
• Suicidal thoughts
• Academic and bizarre behavioral changes reported by friends, teachers, and close ones

Whether mild or severe, any of these signs is a cause for concern, especially if they are seen over a period. If you think your teenager might have symptoms of schizophrenia, talk to them and take them for an evaluation by a mental health professional as soon as possible (13).

How Is Schizophrenia Diagnosed In Teens?

No specific lab tests exist for the diagnosis of schizophrenia. Instead, the diagnosis involves physical examination, assessing the history and symptoms, and ruling out other mental health disorders such as depression, anxiety, substance misuse, post-traumatic stress disorder, and bipolar disorder.

A mental health professional may do a complete evaluation to analyze the symptoms and provide a detailed view of the teen’s condition. A mental health screening involving an overall personality check and asking for the child’s thoughts, family history, feelings, emotional states, moods, substance use, behaviors, and suicidal tendencies may be done by the professional. An MRI or CT scan might be performed at the doctor’s request to confirm or rule out other conditions (14) (15). Psychometric tests, such as the Rorschach test, can also be used for diagnostic clarification.

What Are The Treatment Options Available For Schizophrenia?

The treatment for schizophrenia is based on the teen’s symptoms, age, severity, and overall health status. Hence, the treatment has to be individually tailored. Usually, it is a blend of medications and therapies designed according to one’s specific needs (13) (16).

• Antipsychotic medications are given as the first line of treatment after the first known schizophrenic episode, to reduce the symptoms. The medications include typical (Haloperidol, Loxapine, Molidone, etc.) and atypical ones (Clozapine, Risperidone, Olanzapine, etc.). These are prescribed as pills (orally) or injectables (long-acting), depending on the severity and progression of the condition.

• Mood-stabilizing agents may also be prescribed in the initial phases.

• Other treatments include behavioral therapy and psychotherapy, which help the teen normalize their thought processes and cope with unwanted negative feelings, anxiety, and stress.

• Family therapy can let you and your spouse help your teen cope with the condition better. It enables you to educate yourself about the different aspects of schizophrenia and solve the practical issues faced by your child.

• Specialized educational or personalized activity programs are exclusively available in various care treatment centers. The therapies may include but are not limited to art and recreational therapies, speech and language therapy, and social skills training.

These therapies can help in bringing about a positive change in the condition of your teen. And a combination of medications and therapies is known to provide the best results.

Can Schizophrenia In Teens Be Prevented?

Unfortunately, schizophrenia cannot be prevented. However, early intervention and treatment might help reduce the symptoms and complications of this condition in teens.

Certain events that can be prevented are pregnancy-related complications (malnutrition), childhood brain injuries, drug abuse, and traumatic experiences.

In addition, ensure the teen does not miss their medication doses to avoid further complications and hospitalizations. Enrolling your teen in web-based patient portals for mental illnesses might also help you keep track of their health status and recovery progress. The parents or caregivers should also make sure to visit the teen’s physician periodically to keep an update about their condition and the effectiveness of the treatment (15).

References

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Reviewer

Dr. Neha Bhave SalankarMD

 

Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur and has around 11 years of experience in the field. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS and MD psychiatry.

Read full bio of Dr. Neha Bhave Salankar