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The Royal College of Psychiatrists Improving the lives of people with mental illness

Mental Heath and Growing Up Factsheet

Schizophrenia: information for parents, carers and anyone who works with young people


Schizophrenia

About this leaflet

This is one in a series of factsheets for parents, carers, professionals and young people entitled Mental Health and Growing Up. This factsheet explains what schizophrenia is and gives practical help and advice about how and where to get help for young people affected by this mental illness.

What is Schizophrenia?

  What are the symptoms?

Schizophrenia is a serious mental illness that affects thinking, emotions and behaviour. It is the most common form of psychosis.

 

Over a lifetime, about 1 in 100 people will develop schizophrenia. It is most likely to start between the ages of 15 and 35 years, but can sometimes occur in younger children. The illness might last for a long time and can be very disabling.

 

What causes schizophrenia?

We do not know the exact cause of schizophrenia, although it does seem to relate to chemical imbalances in the brain. Research shows that having parents or close relatives with mental illness, experiencing stress and using drugs like cannabis can all be associated with having schizophrenia.

 

Schizophrenia affects everybody differently. There are two groups of symptoms, which are described as ‘positive’ and ‘negative’.This doesn’t mean some are good and some are bad; more that some are about ‘doing’ things or experiencing symptoms and some are about ‘not doing’ things (see below). Young people with schizophrenia often have a mixture of the two.

Sometimes, the illness develops slowly and can be hard to spot, although some young people become unwell very quickly.

 

Positive symptoms

  • Strange beliefs or delusions are very strongly held beliefs that are not only untrue, but can seem quite bizarre. The young person may believe that they are someone different, a world leader or celebrity for example, or they may believe that other people are ‘out to get them’. They will believe this is true no matter what you say.
  • Thought disorder is when someone is not thinking straight and it is hard to make sense of what they are saying. Their ideas may be jumbled up, but it is more than being muddled or confused.
  • Hallucinations are when someone sees, hears, smells or feels something that isn’t really there. The most common hallucination that people have is hearing voices. In schizophrenia, hallucinations are totally real to the person having them. This can be very frightening and can make them believe that they are being watched or picked on. People who are having these experiences may act strangely. For example, they may talk or laugh to themselves or appear to be talking to somebody that you can’t see.

Negative symptoms

The young person suffering from schizophrenia can become withdrawn and appear unemotional. They seem to lose interest, stop washing regularly and can spend a lot of time on their own. They may not be able to carry on with their normal activities, and usually find it difficult to concentrate on work or study.

Other symptoms

Some young people can become frustrated and angry even towards their own family. Others may take drugs or drink alcohol to feel better. Some find the symptoms so distressing that they want to self-harm.

 

Despite how they are described in the media, people suffering from schizophrenia are not more dangerous or violent than anyone else. However, they may come across as worrying and unpredictable, especially when they feel frightened by their strange experiences.

 

How do I get help?

 

What is the treatment for schizophrenia?

The earlier it is recognised that a young person is ill, the better the chances of getting effective treatment. This speeds recovery and reduces the long-term harm. Some people can make a complete recovery.

 

Even if your child won’t come with you, you might find it helpful to talk to your GP. It is likely that you will be referred to a psychiatrist in a child and adolescent mental health service or an Early Intervention Team or Service (EIS) if this is available locally. EIS professionals are specialists in working with young people with psychosis. If your child is very unwell, they may need admission to hospital for a period of time until their condition stabilises.

 

Medications called ‘antipsychotics’ are an important part of the treatment of schizophrenia. They treat the symptoms of the illness, but tend to be more effective with positive symptoms than negative symptoms. Hallucinations and delusions may take weeks and sometimes months to improve. Unfortunately, schizophrenia can recur, and may need long-term treatment.

A number of different antipsychotics are available, and the psychiatrist will advise which is the best for your child. Sometimes, several different drugs will need to be tried to find the most effective for a particular young person..

As with all medication, there can be side-effects. The psychiatrists will advise on these and what can be done to help. The risk of side-effects needs to be balanced against the risk of the damaging effects of the illness on a young person’s life.

Some medicine for the treatment of schizophrenia are 'unlicensed' in children and young people.  This does not mean they do not work, but simple that the drug company has not applied for a license. If you are worried about this, you should speak to your doctor or pharmacist.

 

Practical help and support  

Megan talks about her 19 year old son Justin

It is crucial that medication is combined with practical help and support for the young person and their family. This should cover:

 

  • Understanding the illness

It is very important that the young person with schizophrenia and their family are helped to understand the condition.

  • Resuming education, training or starting work

An episode of schizophrenia can interfere with education because it is difficult for a young person to learn when unwell. An important part of recovery is to plan for their future.

  • Family relationships

Experiencing stress, hostility and criticism can all increase the chance of relapse. Families need help with recognising and reducing these factors, and with how best to support the young person. As is a normal transition for others of their age, young people with schizophrenia can benefit from leaving home and living independently; the professionals working with them will be able to support the process.

  • Coping with specific symptoms

Some people with schizophrenia find Cognitive Behavioural Therapy (CBT) helpful in managing hallucinations, in addition to the medicine prescribed.

 

   "When Justin was 15, he seemed like a typical teenager at home. Suddenly he stopped going out on his bike, and instead spent long hours in his room on his computer. He did not show any interest in doing the engineering degree at university, his childhood dream. Instead he said he could create his own lab and make amazing discoveries. I brushed aside this as fantasy, but over next few months he only talked about this more and more, and spent most of his time on the computer exploring science websites, books. He seemed to talk like he knew everything, but it actually none of it made any sense. He started collecting batteries, wires in his room, staying awake at night, not bothering to talk, eat or sleep. I got really worried when he refused to go to school after shouting at the teacher.

 

My neighbour told me to go to the GP. She had someone in family with mental illness. I was really scared, felt devastated when our GP referred Justin to the Child and Family Mental Health Service (CAMHS). It was really difficult at first, even to get Justin to the appointments or to talk. But the mental health nurse and practitioner were very good. They knew immediately that something was wrong. Once Justin had been put on medication, they met with the school to help him complete his subjects.

 

Justin was upset and depressed once his strange thoughts went away. He even thought of suicide, but CAMHS were there all the way, never made him feel it was his mistake or that it cannot get better. They were even there when Justin moved to adult services and supported accommodation. He is in College now, even has a girlfriend. He has had few ups and downs, but schizophrenia doesn’t seem to be as bad as they show in movies.

 


Further info  

References

Young Minds - A charity that offers information to young people about mental health and emotional well-being.

Mind: national mental health charity for England and Wales.

TalktoFrank for drug induced psychosis.

 

 

Rutter’s Child and Adolescent Psychiatry, Fifth Edition (2008). Publisher: Wiley-Blackwell.

National Institute of Clinical Excellence (NICE, 2009), Clinical Guidelines, CG82: Core interventions in the treatment and management of schizophrenia in primary and secondary care (update).


Revised by the Royal College of Psychiatrists’ Child and Family Public Education Editorial Board.

Series Editor: Dr Vasu Balaguru

This leaflet reflects the best possible evidence at the time of writing.

© March 2012. Due for review March 2014. Royal College of Psychiatrists

Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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