Childhood schizophrenia: How early can it be diagnosed?

My 12-year-old son exhibits all the symptoms of childhood schizophrenia, but his therapist and doctors won't diagnose him because of his age. No one disputes that he meets the criteria for schizophrenia. At what age can he be diagnosed?

- No name / Illinois

Answer

Early childhood schizophrenia is rare. But schizophrenia can be diagnosed in children as young as 8 years old.

Typically, schizophrenia first appears in the late teens and early 20s. Because of its lifelong implications and the complexity of its symptoms, doctors are reluctant to make a diagnosis of schizophrenia until other potential illnesses have been carefully considered and appropriately excluded. Also, because childhood schizophrenia is rare, doctors not specializing in pediatric psychiatry may have limited experience with diagnosing childhood schizophrenia.

To provide the most accurate diagnosis and safest treatment recommendations, your child's doctors will conduct:

• A complete medical, social and family history
• Interviews with the child and parents or guardians to assess possible psychotic symptoms, behavior changes and other potential psychiatric disorders
• Tests to assess cognitive skills and functional abilities in daily life
• A review of school records and interviews with teachers and other school staff regarding notable changes in school behavior and performance
• Blood and brain-imaging tests to rule out other medical conditions

This process takes time. Your psychiatrist will make a diagnosis of schizophrenia only if psychotic behaviors and other diagnostic criteria continue for at least six months.

Also, some signs and symptoms of schizophrenia overlap with those of other psychiatric and developmental disorders, including bipolar disorder, severe anxiety disorder, severe depression, autism and personality disorders. Your child's doctors will want to rule out these disorders before making a diagnosis of schizophrenia.

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