Diagnosing schizophrenia is a process that takes many months in an adult. During this process with our adult daughter in recent years, we were reminded of many things from her childhood and teen years that made us wonder if the signs were there early on. Had we recognized those signs or known they were signs, could we have prevented or lessened the impact of this terrible illness on our daughter later in life? I found myself really wondering about that as time went on and we learned more about this illness.

At a recent schizophrenia workshop we attended in our local county, I specifically asked if there were any symptoms in childhood that could indicate a young person would develop schizophrenia later in life. I was told that there are, and that these symptoms are called prodromal symptoms. Prodromal means precursory or premonitory, which basically means they precede or indicate the approach of another, or they give warning of symptoms of disease.

However, it was also said at the workshop that while prodromal symptoms can give general clues, schizophrenia cannot be "detected" early because the early symptoms could also be attributed to something else entirely. This is why a firm diagnosis cannot usually be made until the child reaches adolescence or adulthood and begins experiencing psychosis.

Prodromal symptoms involve sensitivities to sensory stimuli, such as changes affecting colors, sounds and shapes. These involve an overload, due to internally generated stimuli, and also distraction, which is the inability to select relevant aspects of the environment to pay attention to, while at the same time ignoring the irrelevant aspects. While the first signs can be a change in friends, a drop in grades, sleep problems and irritability, prodromal symptoms may also include bad moods, fighting, poor attention spans, misperceptions, suspiciousness, social withdrawal, depression, marked isolation, major impairment with regard to role functioning, marked lack of initiative, interest and energy, as well as anger, blunted feelings and odd or eccentric ideas.

There are many reasons a child or teenager would exhibit these symptoms. Because the impact of a psychotic illness on the adolescent is so huge, it is so important to detect and possibly prevent these illnesses as early as possible. Schizophrenia strikes when the young person is going through the changes from childhood to adulthood, when he or she is forming self-image, intimate friend and family relationships, peer group identification, religious commitments, education and vocational goals, sexuality, personal development and higher cognitive development, which includes abstract thinking and also empathy.

Being the parent of an adult daughter with schizophrenia, I was very excited to hear about a new study that is going to be done very soon regarding this very subject. This national initiative titled "Early Detection and Intervention for the Prevention of Psychosis Program" (EDIPPP) is going to focus on reducing the impact of psychotic illness on young people and their families through early detection and intervention. They will be trying to identify those between the ages of 12 and 25 who show early symptoms, but don't yet have the disabling psychotic disorder.

The EDIPPP study is to be implemented in four specific areas across the country involving cities in Maine, California, Michigan and Oregon in hopes that these services will become more broadly available elsewhere by demonstrating the positive impact in the areas that are doing this type of work.

Our daughter had many symptoms as a child, teenager and young adult, and yet no one ever identified any of them as being associated with the prodromal symptoms of schizophrenia. Among the few diagnoses suggested in her late teens and very early 20s, schizophrenia was never one of them. She was in full-blown psychosis in her mid- to late-20s before we had any idea what had been happening to her the few previous years. Had someone recognized her symptoms early on as the prodromal symptoms associated with schizophrenia, then she could have been treated much earlier than she was and possibly could have avoided the resulting psychosis that can lead to disability.

While it's too late for this particular program to benefit our daughter, this is one program I do wish they had done when she was a teenager. I am very hopeful it will benefit many other young people and their families! The people involved in this program will reach out to teachers, social workers, ministers and others who regularly work with young people, and teach them how to identify early signs of psychotic illness. I cannot stress enough how important this is. The longer a person is in psychosis before getting the help they need, the harder it is to pull them back out of the psychosis that leads to disability. The hope is that the earlier the detection of a possible psychotic illness, the better the person's chances are for a much more normal life.

If this particular program is not available in your area, then you can still talk to your county and see if something similar can be implemented. If you suspect a child or teenager you know may have these prodromal symptoms, then please don't hesitate to have him or her evaluated by a professional. I cannot stress enough how important it is to catch these psychotic illnesses early.

References:

Yamhill County Adult Mental Health and Schizophrenia Workshop presented by Sally Godard, MD; Bruce Neben, LPC, PsyD; and Betty Foufos, MA.