The term schizophrenia was first used by Eugen Bleuler (1911). Since schizophrenia causes serious problems in social and academic life, it is very important to provide early treatment and support.
Schizophrenia usually begins insidiously (80-85%) during childhood and adolescence. Before the disorder, they are generally described as strange, eccentric, shy, anxious, lonely children.
The prevalence of schizophrenia is generally 0.6-1%. It most commonly begins between the ages of 20-30 (peaks at the age of 20-21). If schizophrenia starts before the age of 18, it is called early onset; if it starts before the age of 13, it is called very early onset. However, it is very rare for it to occur before the age of 13, and 10-15% of all schizophrenia patients have their onset under the age of 15.
The older the child, the more similar the findings of schizophrenia are to those of adults. It is generally accepted that positive psychotic symptoms do not appear before the age of 6. Delusions usually appear after the age of 6, and hallucinations usually appear after the age of 9. Psychotic symptoms in children are generally not foreign to the self. Since children cannot easily express all their emotions, delusions in children are simpler than in adults. Approximately 50% of children have delusions and are characterized by persecution, somatic preoccupations, ideas of reference, grandiosity, or religious nature. Most hallucinations in children (approximately 80%) are auditory. These are generally accusatory or commanding voices, mutual conversation, and comments about the child.
It is 1.5-2 times more common in boys than in 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) types are usually seen in children.
There are different diagnostic criteria for schizophrenia.
Schizophrenia according to DSM-IV-TR diagnostic criteria:
A-Characteristic Symptoms: At least 2 or more of the 5 diagnostic criteria persist for a period of one month (1 if there is a bizarre delusion). one symptom is enough; if there are hallucinations and voices talking about the person's thoughts and behaviors, 1 symptom is enough)
1- Delusion,
2- Hallucination,
3- Disorganized or incoherent speech,
4- Disorganized or catatonic behavior,
3- Disorganized or incoherent speech,
4- Disorganized or catatonic behavior,
p>5- Negative symptoms (shallowness of affect, poverty of speech, apathy),
B- There must be social/occupational dysfunction
C- Symptoms must last at least 6 months ( At least 1 month out of 6 months must include A diagnostic criteria)
Schneider schizophrenia diagnostic criteria
1. Auditory hallucinations (hearing one's own thoughts, discussing and commenting about oneself sounds)
2.Physical passivity (body being affected by external forces)
3.Thought disorders (stealing, inserting, reading, broadcasting thoughts)
4 .Delusional perception (perception disorders due to delusions)
5.The feeling that one's behavior is under the influence of others.
CRITERIA THAT SHOW GOOD/BAD PROGRESSION IN SCHIZOPHRENIA DISORDER:
1. A late start indicates good progress. The course is worse and more chronic, especially when it starts under the age of 12.
2.Acute and sudden onset indicates a better course than latent and slow onset.
3.There is a significant stress factor at the beginning. indicates a good prognosis.
4. The better the social, social and academic adaptation before the disorder, the better the prognosis.
5. Co-occurring with an additional psychological disorder such as depression and OCD. The presence of a disorder indicates a bad prognosis.
6. Having a good environment, family and educational support indicates a good prognosis.
7. The presence of positive symptoms (delusions, hallucinations, ...) in the patient indicates a good prognosis.
9. Having a family history of mental disorders such as schizophrenia and mood disorders indicates a poor prognosis.
DIFFERENTIAL DIAGNOSIS
1.Pervasive developmental disorders (autism, asperger syndrome ,…)
2.Personality disorders (schizotypal, borderline, schizoid, paranoid)
3.Schizophreniform disorder
4.Brief psychotic disorder
5.Mood disorders
6.Organic syndromes.
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