Very Early-Onset Schizophrenia in a 7-Year-Old Girl

Schizophrenia most commonly starts during early adulthood but it can emerge during childhood. Pediatric schizophrenia is used to describe schizophrenia occurring before 18 years of age. It can further be categorized into early onset type which occurs prior to 18 years and the very early onset type occurring prior to 13 years.

Miss AD, a 7-year-old female presented to our facility about 1 year ago with a 3-months history of illness. Initially, she stopped communicating with anyone; there was associated social withdrawal, sluggishness and decline in her academics. A few weeks later, she started talking and laughing to herself and 2 weeks prior to presentation, she started seeing strange things in clear consciousness and claiming her classmates were ganging up against her. Her teachers and parents were ignorant of the nature of her illness at the onset and as such, she was maltreated.

At presentation, a diagnosis of very early onset schizophrenia was made and she was commenced on treatment with oral Risperidone which was gradually increased over a period of 1 year of her ongoing treatment to 2mg total daily dosage. Additionally, oral chlorpromazine and Benzhexol were added; she is currently on 50mg nocte and 0.125mg daily respectively. During the course of her treatment, she showed significant improvement but no complete remission, residual symptoms such as starring on-end with occasional talking and laughing to herself persisted.