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For many people with schizophrenia, symptoms often manifest in adolescence or early adulthood; the most common time of appearance is in mid-to-late 20s. Schizophrenia can be difficult to manage medically and disruptive to people’s lives. But it can be even more challenging when it appears in younger individuals—a rare form called childhood-onset schizophrenia, or COS. In this subset, children may experience symptoms as young as three years old (though the average age of onset is 10 years old). 

Identifying the Genetic Underpinnings

In the past, research has suggested a link between schizophrenia and heredity. There is a growing belief that schizophrenia has an underlying genetic basis which may be triggered by environmental or lifestyle factors, such as marijuana consumption. Yet there has been little information discovered around the cause of childhood-onset schizophrenia. According to Times of Israel, this may recently have changed following research performed by Columbia University and the Hebrew University of Jerusalem. 

The 10-year study, published in Schizophrenia Research, centered around 33 people with childhood-onset schizophrenia, as well as their families. It builds upon research performed since the Human Genome Project’s completion. This research team performed exome sequencing with a particular focus on coding sequences in DNA. They found that 21.2% (7 children) had gene variants that had never been previously linked to schizophrenia. These variants—some inherited and some spontaneous—were MICU1, CLTC, CLCN3, CHD2, IGF1R, GRIA2, and ANKRD11. 

Although those variants have not been associated with schizophrenia previously, they have been linked to central nervous system development (and developmental issues) and mitochondrial damage. More research is needed in the future to better understand these variants. However, the research team believes that this could provide a jumping off point both for a better understanding of the etiology of COS and therapeutic development in the future. 

What is Childhood-Onset Schizophrenia?

Childhood-onset schizophrenia is a rare and severe mental disorder characterized by abnormal perceptions of reality. Children with this condition often do not respond as well to treatment as their older counterparts. Someone with a first-degree relative with COS also has a 25% chance of having schizophrenia themselves. 

Symptoms and characteristics may include:

• Late or unusual walking/crawling
• Language or speech delays
• Anxiety and/or depression
• Attention deficit hyperactivity disorder (ADHD)
• Obsessive compulsive disorder (OCD) 
• Difficulty sleeping
• Hallucinations 
• Disordered thinking and behavior
• Delusions

Children with childhood-onset schizophrenia may seem unmotivated, struggle with school or socializing, argue with family, isolate themselves, self-harm, or overuse substances. These symptoms or effects may progress with age. 

People with COS require life-long treatment. A potential treatment plan includes antipsychotics, hospitalization, life skills training, and psychotherapy. It is best to speak with your care team to identify the best line of treatment.