Very early-onset psychosis/schizophrenia: Case studies of spectrum of presentation and management issues

Abstract

Schizophrenia occurs very uncommonly in children younger than 13 years. The disease is preceded by premorbid difficulties, familial vulnerability, and a prodromal phase. The occurrence of positive psychotic symptoms such as delusions and hallucinations depends on the level of cognitive development of child. Furthermore, at times it is very difficult to differentiate the psychopathology and sustain a diagnosis of schizophrenia in view of similarities with disorders such as autism, mood disorders, and obsessive compulsive disorders. Here, we present three case studies with varying presentation of childhood-onset psychosis/schizophrenia and associated management issues.

A Case of New-Onset Obsessive-Compulsive Disorder and Schizophrenia in a 14-Year-Old Male following the COVID-19 Pandemic

“…Throughout the hospital course, the patient's diagnosis was changed from ADHD to both OCD and early-onset schizophrenia. Previous research showed that obsessive-compulsive disorder is frequently observed in patients during their first episode of schizophrenia in young adults [ 21 ]. However, recent research showed that a substantial proportion of adolescent schizophrenia patients are also diagnosed with OCD [ 22 ].…”

“…The disruption of daily life routine and social isolation from school environment and peers, and with their inability to comprehend the consequences of the pandemic, have led 3 Case Reports in Psychiatry many children and adolescents to experience stress [7]. In children and adolescents, stress may manifest as anxiety, irritability, insomnia, and clingy behavior related to emotional distress from experiencing social isolation and the death of relatives during the pandemic [21]. The patient experienced social isolation when he began remote learning.…”