Child Paranoid/Schizophrenia

[Hary__0]

Posted by Harry on July 13, 1999 at 03:24:16
My son Tommy is now 9 years old and he is well liked by his peers.  However, he is always not sure of himself i.e. lacking of self confident.  Over the last few years, occasionally he has been disturbed by things that I shall think a normal child would not be affected.  I am merely comparing Tommy to his little brother who is 6 1/2.
For instance we have recently watched the Disney's new movie "Tarzen" and that Tommy was very much disturbed by the scene that the leopard killed Tarzen's parents, eventhough there was no actual killing shown in the movie.  After seeing the movie,for 2-3 days Tommy was sad and felt scared.  When asked what is scaring him, my son suggested that some bad guy may kill him or us.  My worry is that a 9 year old should be able to distinguish between real and friction.  I am also noticing bad news such as murdering cases would easily trigger my son to apply himself as the victim.  During Tommy's depressed period,he would ask to watch his favorite comedy as the mean for his escape of his fear.
Since my wife's second cousin happened to have Schizophrenia and I undersatand that this illness is hereditary, is there any sign of an early stage of Schizophrenia in my son's situation?
I would appreciate that you let me know what to look for and if indeed my son has the symptom of Schizophrenia.
Thank,
Harry

Posted by HVMA  Ph.D. - KDK on July 13, 1999 at 12:51:04
Dear Harry,
Schizophrenia is a psychotic disorder characterized by such symptoms as impaired ability to think clearly; delusions; hallucinations; blunted affect; apathy; social withdrawal. It is typified by quite poor reality testing and often bizarre behavior. Approximately 1% of the population will display symptoms of schizophrenia; the likelihood of developing schizophrenia increases if there is a family history of the illness (particularly in one or both parents). Onset of schizophrenia is usually between the ages of 16 and 25; onset after age 30 is unusual; onset after age 40 is pretty rare.
Schizophrenia is quite uncommon in children, and often does not appear in as distinct a fashion as it does with adults. Children with schizophrenia may demonstrate changes in their behavior slowly over a stretch of time. Symptoms might include: hearing voices or seeing things that are not real; confused thinking; bizarre thoughts; confusing fantasy with reality; odd behavior; serious difficulty both making and keeping friends.
The behavior you describe in Tommy is not suggestive of schizophrenia. His reaction to the movie did not reflect so much an inability to distinguish fantasy from reality, as it did a sensitivity and worry generated by the movie.
Such worries need not be symtomatic of an emotional disorder, though they are seen in children who display, for example, mood or anxiety disorder (e.g., Generalized Anxiety Disorder, Separation Anxiety Disorder). Some children are sensitive and anxious as a matter of temperament - in my clinical practice I refer to them as 'anxious worriers'.
It is worthwhile to keep in the back of your mind that there is some family history of schizophrenia, though I don't think you need to be alarmed about this. Your son's behavior does not suggest incipient schizophrenia (or psychosis of any sort). It might be worthwhile to seek an evaluation by a child mental health professional for two purposes: (a) to rule out the presence of an emotional disorder (vs. anxious/worried temperament); and (b) to receive guidance re: management.
This information is provided for purposes of general medical education. Please consult your health care providers for diagnostic and treatment options that pertain to your situation.
*Keyword: Anxiety; Schizophrenia; Fears; Temperament

Posted by Harry on July 13, 1999 at 22:25:59
Thank you KDK for your helpful response.  I certainly will look for child mental professional advise on Tommy case as you have suggested.

Posted by Harry on July 14, 1999 at 22:00:36
Before I take my son to see a mental health professional, perhaps you can give me some advises on how to deal with children who are as you described as "anxious worriers" and extremely sensitive.
Many thanks,
Harry

Posted by HVMA Ph.D. - KDK on July 15, 1999 at 08:51:42
Dear Harry,
Children who are anxious/worried (if indeed such a description 'fits' your son) tend to be sensitive, sometimes overly so, to their physical and social environments. They often feel vulnerable and overwhelmed, even when (from an objective standpoint) they are not.
Consequently, it is important to help them articulate the nature of their worry, and not to reassure them too much, because such reassurance can come across as 'there's nothing to worry about', when the child actually feels quite worried. Instead, helping the child to articulate the worry can identify any misconceptions or misunderstandings that may be exacerbating the worry.
In addition, it's helpful to guide such children toward a problem-solving stance, whereby they learn that they can take measures to address their concerns. Sometimes such children tend to see themselves as the victims of their physical and social worlds and as unable to act effectively to help themselves. Asking them "What would be helpful?" "What can you do to make this better?" "What would you like to do about this?" suggests that they can be active in solving their worries. The more capable/competent they become, the less worried they become.
In The Challenging Child: Understanding, Raising and Enjoying the Five "Difficult" Types of Children (by Stanley Greenspan, MD), Chapter 3 addresses issues about what he terms the 'sensitive' child. Such children are typical of the kids I call 'anxious worriers'. Greenspan's book might be useful to you.
And remember, via the consult with a pediatric mental health clinician, even if the 'diagnosis' indicates no emotional disorder, you can receive valuable assistance re: dat-to-day parenting. Many of the consults we do in the child mental health field are with parents of perfectly normal children. The consult often addresses common parent-child interactions and issues.
Good luck,
Dr. K
*Keyword: Anxious, Worried, Sensitive, Fearful