Schizophrenia is a complex and severe mental health disorder that usually appears in late adolescence or early adulthood. However, when it develops in youngsters, it is referred to as early-onset schizophrenia (EOS), an uncommon but devastating condition that can damage a child's development and quality of life. In an email to Drug Today Medical Times, Dr. Sushma Gopalan, a child psychologist and child life specialist at Aster CMI Hospital in Bangalore, provides light on this lesser-known ailment, including its early symptoms, potential causes, and treatment techniques.

Dr. Gopalan stresses that schizophrenia in childhood typically differs dramatically from adult-onset schizophrenia, which makes diagnosis difficult. "In children, the symptoms may appear gradually and often overlap with other developmental or emotional issues," the doctor states. Key early warning indicators include separation from family and friends, a rapid reduction in academic performance, and a loss of interest in previously loved hobbies. Cognitive deficits, such as difficulty concentrating, memory problems, and disorganised thinking, become apparent. Common red flags for psychotic symptoms include hallucinations and delusions, as well as mood abnormalities such as worry or irritation.

Dr. Gopalan believes that one of the most difficult aspects of diagnosing EOS is the subtlety of the early symptoms. "Children with early-onset schizophrenia often do not present with the overtly dramatic signs seen in adults, making it difficult for parents, teachers, and even healthcare professionals to recognise the condition early," she tells me.

Dr. Gopalan emphasises that parents, teachers, and carers have an important role in detecting early indications of schizophrenia, and any continuous display of numerous symptoms for more than six months should trigger a visit to a mental health expert. "Timely intervention can significantly improve outcomes," she remarks. People often use a complete evaluation, which includes interviews and psychological tests, to provide a diagnosis.

While childhood-onset schizophrenia remains uncommon, affecting around one in every 40,000 children, Dr. Gopalan notes that a perceived increase in instances could be related to improved diagnostic procedures rather than an actual increase in prevalence. "As awareness around mental health improves, we are better equipped to identify schizophrenia in children early, which was not always the case in the past," the researcher claims.

Dr. Gopalan identifies three significant elements that may contribute to the disorder, although the origins of schizophrenia, particularly in youngsters, remain poorly understood. "Genetic predisposition is one of the most significant risk factors," she tells me. "Children with a family history of schizophrenia are more likely to develop the disorder." Schizophrenia is also closely associated with aberrant brain structure and changes in neurotransmitter activity, particularly dopamine and glutamate levels. Furthermore, prenatal factors like maternal illnesses, malnutrition, or pregnancy difficulties can raise the risk.

Environmental factors also play a part. According to Dr. Gopalan, significant amounts of stress or trauma during early childhood might develop schizophrenia, particularly in genetically predisposed youngsters.

Dr. Gopalan emphasises the necessity of early intervention when controlling EOS. "With the right treatment, children with schizophrenia can lead more fulfilling lives," she tells me.

Medication, therapy, and, in severe cases, hospitalisation are common forms of treatment. Doctors frequently recommend antipsychotic medicines to treat psychotic symptoms, but careful monitoring is necessary to prevent dangerous side effects in children.

Cognitive-behavioural therapy (CBT) can help children control their symptoms, while family therapy can provide support and enhance communication in the home. In some situations, a short-term hospital stay may be necessary to stabilise the youth and protect their safety.

While a child's path with early-onset schizophrenia might be difficult, Dr. Gopalan remains optimistic about the future. "Advancements in research, medication, and therapy have created a more supportive environment for affected children and their families," she says. Early diagnosis and management can help children manage their disease, leading to increased functioning and quality of life.

Dr. Gopalan emphasises the necessity of being vigilant and seeking expert help if they notice any worrying behaviours. Society can better help children with schizophrenia by raising awareness and cultivating empathy, ensuring they may have healthy, stable lives despite the obstacles they experience.

Dr. Gopalan's views provide a thorough understanding of early-onset schizophrenia in children, emphasising the importance of early intervention, increased awareness, and ongoing research to enhance the lives of those affected.