Clinical Profile of Childhood Onset Schizophrenia in India

IntroductionIn view of the rarity of schizophrenia in children and differences in manifestation across cultures, aninvestigation was carried out to look into the clinical profile of schizophrenia in children in Varanasi,India (Eastern Pradesh).Method30 patients meeting the criteria for schizophrenia (ICD 10) were selected from the child GuidanceClinic of the University Hospital, BHU, Varanasi. Details of demographic data, psychiatric history, andphysical & mental status examination findings were recorded on a structured proforma. The intellectuallevel of the patients was assessed by a battery of psychological instruments. Evaluation of patients wasdone on the KIDDIE-SADS-PRESENT EPISODE for the symptoms of the present episode. Relevantinvestigations such as EEG, CT scan of brain, hormonal assays were carried out.ResultsThe mean age of the patients was 10.8 years (range 4-16 years). 60 % were males, 63% has rural /semiurban domicile, 80 % were from middle class socioeconomic class and 73 % were educated till 5thstandard. Past history of major physical illness was recorded in 33 % of the cases. There was co-morbidpsychiatric illness in t0 cases; mental retardation, 8; epilepsy 2). Family history of psychiatric illnesswas recorded in 6 first degree relatives (schizophrenia, 2; psychosis NOS, 2; suicide, 1; and epilepsy,1). There was past history of psychiatric illness in 2 cases (schizophrenia, 1; cannabis inducedpsychosis, 1). The onset was acute in 50 % of the cases. The mean duration of illness was 1.18 years(range 1 month to 4 years). The symptoms of the present episode were emotional disturbance(inappropriate affect, fearfulness, anger, suspiciousness, crying, lability and blunt affect) in 15 cases,bizarre behaviour in 14 cases, disturbance of motor behaviour (increased activity, decreased activityand stereotypy) in 14 cases, formal thought disorder (derailment, incoherence and neologism) in 10cases, delusions in 6 cases, and hallucinations (auditory, visual and tactile) in 5 cases. Abnormal EEGwas reported in 5 cases and diffuse brain atrophy in the MRI brain scan of one patient