schizophrenia in children
Introduction
Introduction to children with schizophrenia Childhood schizophrenia is a psychiatric disorder in which children's spirits are more common. Schizophrenia can occur in adults and children, and children with schizophrenia also have their own clinical features. The choice of various treatments, in addition to the main clinical symptoms, should be combined with the specific conditions of the child, such as age, physical development, nutritional status. The incidence of mental illness in the family of this disease is higher (16% to 64%). Xia Zhenyi et al (1982) believed that the genetic pattern of childhood schizophrenia was multi-genetic, and its heritability was 70%. The incidence of this disease in first-degree relatives was 4.0% for parents and 6.7% for the same chest. Some people think that parents are suffering from schizophrenia, and their children have a risk of schizophrenia of about 40%. One of the parents has a risk of comorbid disease of 7% to 17% of their children, indicating that genetic factors play an important role. . basic knowledge The proportion of illness: the incidence is extremely low, about 0.0001% Susceptible people: more common in children Mode of infection: non-infectious Complications: affective disorder
Cause
Causes of childhood schizophrenia
Genetic factors (25%)
The incidence of mental illness in the family of this disease is higher (16% to 64%). Xia Zhenyi et al (1982) believed that the genetic pattern of childhood schizophrenia was multi-genetic, and its heritability was 70%. The incidence of this disease in first-degree relatives was 4.0% for parents and 6.7% for the same chest. Some people think that parents are suffering from schizophrenia, and their children have a risk of schizophrenia of about 40%. One of the parents has a risk of comorbid disease of 7% to 17% of their children, indicating that genetic factors play an important role. .
Organic factor (15%)
Children with this disease have a history of perinatal damage. Delayed development of the nervous system, soft signs of the nervous system and EEG abnormalities are also common. In recent years, studies have found that the evoked potential P300 latency is significantly shortened and the amplitude is reduced in children with schizophrenia; CT scan, magnetic resonance imaging (MRI) The results of the study suggest that frontal lobe, basal ganglia, and temporal lobe lesions are closely related to schizophrenia.
Psychosocial factors (15%)
Children are subjected to intense trauma, such as divorced parents, deaths of relatives, unsuccessful students, and other life events that induce schizophrenia, and psychosocial factors also have an important impact on the continuation and prognosis of the disease.
Pre-disease personality characteristics (10%)
The pre-disease personality of this disease is mostly introverted. On the basis of personality deviation or imperfection, it is affected by environmental factors and increases the risk of onset.
Biochemical factors (5%)
There are few studies on schizophrenia in children. It is generally believed that this disease is associated with insufficient central noradrenergic function in the central dopaminergic system. Some studies have found that plasma dopamine -hydroxylase is elevated in children with this disease, and the cholinergic system is inhibited.
Prevention
Childhood schizophrenia prevention
The cause of schizophrenia in children is still unclear, but it has a lot to do with genetics and environment. The most important point is to understand and understand the symptoms of childhood schizophrenia so that early treatment can be detected early. Prognosis: Follow-up observations showed that the onset age was small, the onset was slow and the production process was slow; the prognosis was poor and the prognosis was poor. Therefore, early diagnosis, timely and active treatment, prognosis for children with schizophrenia Has an important relationship.
Complication
Child schizophrenia complications Complications
There may be symptoms such as affective disorder, speech and thinking disorder, perceptual disorder, abnormal movement and behavior, and activity disorder.
Symptom
Symptoms of schizophrenia in children Common symptoms Children's association and affective disorder hallucinations Tension erotic behavior Titanism Autism Anxiety Mental disorder
1, the onset of the form of slow onset is more, with the increase of age, acute onset gradually increased.
2, early symptoms of children early symptoms of schizophrenia are mainly mood, behavioral changes, sleep disorders, attention to concentration, learning difficulties, etc., some cases early obsessive and forced behavior.
3, basic symptoms
(1) Clinical symptoms are closely related to age factors. The symptoms of younger age are atypical and monotonous; the basic symptoms of adolescents are similar to those of adults.
(2) Affective Disorders: Most of them show solitude, retreat, indifference, alienation with relatives and small partners or nourishment of hostility, no fear, anxiety, spontaneous mood fluctuations and other symptoms.
(3) Speech and thinking disorder: younger cases often show reduced speech, silence, stereotypes, ambiguous speech, poor thinking content, older children may have pathological illusions, content is bizarre and delusional content, and There are often murders, sins, suspects and non-blood reverie.
(4) Perceptual disorder: Children's schizophrenia perception barriers are more vivid and vivid, characterized by horror and image, and may have visual hallucinations, auditory hallucinations (speech or non-verbal), fantasy illusions and perceptual comprehensive obstacles (such as Think that you are deformed, become ugly, etc.), especially for young children.
(5) Abnormal exercise and behavior: often showing excitement, behavioral disorder, no purpose running, or lazy, inability to be dull, dull, or strange movements or postures, often mimicking movements or ritual stereotypes. A small number of children show tension and stiffness, impulsivity, injury and destructive behavior.
(6) Intelligent activity disorder: mainly seen in children with early onset of illness, most cases generally have no obvious intellectual disabilities.
Examine
Childhood schizophrenia examination
The laboratory tests required for this disease mainly include: nervous system examination, electroencephalography, head CT scan, and magnetic resonance imaging (MRI), which mainly exclude mental disorders caused by brain organic changes.
First, through CT or MRI to find the site of brain damage that increases susceptibility to schizophrenia.
Second, the application of functional imaging techniques, such as PET, SPECT, fMRI, to observe the local neuronal activity, thereby establishing a correlation between the nervous system dysfunction and the clinical features of schizophrenia.
Third, through the molecular structure image of brain tissue, to determine the nature of the pathological process of neuronal function defects, such as PET, SPECT to observe neurotransmitter receptors, or MRS to detect neurochemical changes.
Diagnosis
Diagnosis and diagnosis of childhood schizophrenia
1. The standard of symptoms has the basic symptoms of schizophrenia. The main symptoms of thinking association disorder and affective disorder are obvious abnormalities and inconsistencies with the behaviors of the corresponding age behaviors, and at least one of the following symptoms:
(1) The thinking is poor, the association is sloppy or broken, the thinking content is bizarre, and there are pathological illusions and delusions.
(2) Apathy, loneliness, loss of interest, spontaneous mood swings, no reason to cry or anxiety.
(3) Under the condition of clear consciousness, there are perceptual obstacles, behavioral disorders, mental exercise excitement, behavior, violation or slowness.
2, severe standard adaptability is significantly impaired, compared with most normal children of the same age, including abnormalities in the family, school interpersonal relationships, learning performance, labor and self-help ability changes and defects.
3. The time standard course lasts at least 1 month.
4. Exclude brain organic mental disorders, mental disorders caused by physical illness, affective mental disorders and developmental disorders.
Children with schizophrenia often have latent onset, slow progress, atypical symptoms, and difficult diagnosis, especially for young children, so careful examination and in-depth observation, and with children with autism, mental retardation, hyperactivity disorder , conduct disorder and organic mental disorder to distinguish between misdiagnosis or missed diagnosis.
