The term schizophrenia was first used by Eugen Bleuler (1911). Early treatment and support is very important because schizophrenia causes serious problems in social and academic life.
Schizophrenia usually begins insidiously (80-85%) during childhood and adolescence. Before the disorder, they are usually described as strange, eccentric, reserved, anxious, lonely children.
The prevalence of schizophrenia is 0.6-1% in general. It most commonly starts between the ages of 20-30 (peaks at the age of 20-21). If schizophrenia begins before the age of 18, it is called early-onset, and if it begins before the age of 13, it is called very early-onset. However, it is very rare before the age of 13, 10-15% of all schizophrenia patients have onset under the age of 15.
The older the child is, the more similar the findings in schizophrenia to adults. It is generally accepted that there are no positive psychotic symptoms before the age of 6 years. Delusions usually appear after the age of 6, and hallucinations usually appear after the age of 9. Psychotic symptoms in children are usually not alien to the self. Delusions in children are simpler than in adults because they cannot easily express all of their emotions. About 50% of children have delusions and are of persecutory, somatic preoccupations, reference ideas, grandiosity, or religious in character. Most (approximately 80%) hallucinations in children are auditory. They are generally accusatory or commanding voices, conversational, and comments about the child.
It is seen 1.5-2 times more frequently in boys than girls.
There are 5 types of schizophrenia:
1. Paranoid type
2. Disorganized type
3. Catatonic type
4. Residual type
5. Undifferentiated type
Paranoid and undifferentiated (undifferentiated) type are usually seen in children.
There are different diagnostic criteria for schizophrenia.
Schizophrenia according to DSM-IV-TR diagnostic criteria:
A-Characteristic Symptoms: Persistence of at least 2 or more of 5 criteria over a one-month period (1 if bizarre delusion is present). symptom is sufficient; hallucinations, if there are voices talking about the thoughts and behaviors of the person, 1 symptom is sufficient)
1- Delusion,
2- Hallucination,
3- Disorganized or incoherent speech ,
4- Disorganized or catatonic behavior,
5- Negative symptoms (shallow affect, poor speech, apathy),
B- Social/occupational dysfunction
C- Symptoms must last at least 6 months (at least 1 month of 6 months must include criteria A)
Schneider schizophrenia diagnostic criteria
1. Auditory hallucinations (able to hear one’s own thoughts, voices discussing and commenting on themselves)
2.Bodily passivity (be
3. Thought disorders (thought stealing, insertion, reading, broadcasting)
4. Delusional perception (perception disorders due to delusions)
5. A feeling that their behavior is under the influence of others.
CRITERIA INdicating good/bad progress in schizophrenia disorder:
1.Late onset indicates good progress. The prognosis is worse and chronic especially in the beginnings under the age of 12.
2.Acute and sudden onset indicates better prognosis than latent and slow onset.
3. If there is a significant stress factor at the beginning, it shows good progress.
4. The better the social, social and academic adjustment before the disorder, the better the progress.
5. Having an additional mental disorder such as depression and OCD indicates a poor course.
6. Having a good environment, family, education support indicates good progress.
7. The presence of positive symptoms (delusions, hallucinations, …) in the patient indicates good progress.
8. Early diagnosis and early treatment approach shows good progress.
9. Having a family history of mental disorders such as schizophrenia and mood disorders indicates a poor prognosis.
10. Lack of improvement within 3 years after the onset of the disease and exacerbations in clinical findings indicate a poor prognosis.
DIFFERENTIAL DIAGNOSIS
1. Pervasive developmental disorders (autism, asperger’s syndrome,…)
2. Personality disorders (schizotypal, borderline, schizoid, paranoid)
3. Schizophreniform disorder
4. Brief psychotic disorder
5. Mood disorders
6.Organic syndromes,…
