A Review of Schizophrenia in Childhood

Abstract

Schizophrenia may be viewed as a defect in organization resulting from varying combinations of genetic, organic, intrafamilial and social influences. A number of clinical syndromes are described and their differential diagnosis considered. The clinical picture will usually change as the child grows older. Laboratory investigations including EEG. are not helpful. At whatever age the schizophrenic child is seen, the following difficulties are most likely to be encountered: 1) Lack of firm self-identity, disturbed body image and lack of clear ego boundaries. This may be directly apparent or may be determined by the use of projective methods or drawings. These difficulties constitute the core problem and are essential to the diagnosis. 2) Dereistic feeling, thinking and behaviour. 3) The simultaneous presence of impaired and precocious psychological functioning. 4) A loss of normal interests or the appearance of unusual or regressive ones. 5) Language disturbances in content or in rhythm, intonation, pitch, stress or volume. 6) Deficient social relationships with impaired capacity to empathize and a tendency to withdrawal. Certainty about individual identity and what lies outside and inside the ego is essential for normal relationships. Awareness of the changing clinical features of childhood schizophrenia and careful examination for basic problems in identity and distinction of internal and external reality will help in arriving at a diagnosis.