Childhood-Onset Schizophrenia Differential Diagnoses

  • Author: Annemarie K Loth, MD; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Feb 7, 2012
 
 

Diagnostic Considerations

The diagnosis of schizophrenia requires the exclusion of mood disorders with psychotic features (bipolar disorder), substance-induced psychotic disorder, and psychosis due to a medical condition. The following conditions should be considered when evaluating a child or adolescent with suspected schizophrenia:

  • Psychosis secondary to epilepsy; psychosis not otherwise specified; and psychosis, single episode
  • Neurodegenerative disorders
  • Multidimensionally impaired syndrome (not a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV] diagnosis), characterized by emotional lability, distractibility, poor social skills, brief hallucinations, and trouble distinguishing fact from fiction
  • Central nervous system (CNS) tumor
  • Progressive organic CNS disorder (eg, sclerosing panencephalitis)
  • Schizoaffective disorder
  • Chromosomal disorder: 22q11 deletion syndrome

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Annemarie K Loth, MD  Fellow in Child and Adolescent Psychiatry, Indiana University School of Medicine

Annemarie K Loth, MD is a member of the following medical societies: American Psychiatric Association and Indiana Psychiatric Society

Disclosure: Nothing to disclose.

Coauthor(s)

David W Dunn, MD  Program Director, Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Neurology, Indiana University School of Medicine

David W Dunn, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Neurology, American Epilepsy Society, American Psychiatric Association, and Child Neurology Society

Disclosure: Lilly Grant/research funds Other; GlaxoSmithKline Grant/research funds Other; Supernus Grant/research funds Other

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Angelo P Giardino, MD, PhD Clinical Associate Professor, Department of Pediatrics, Baylor College of Medicine; Medical Director, Texas Children's Health Plan, Inc

Angelo P Giardino, MD, PhD is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Professional Society on the Abuse of Children, Harris County Medical Society, Helfer Society, and International Society for Prevention of Child Abuse and Neglect

Disclosure: Bayer Honoraria Review panel membership; Pfizer Grant/research funds Independent contractor; MedImmune Honoraria Review panel membership

Raj K Kalapatapu, MD Fellow, Addiction Psychiatry, Columbia University College of Physicians and Surgeons

Raj K Kalapatapu, MD is a member of the following medical societies: American Academy of Addiction Psychiatry, American Academy of Child and Adolescent Psychiatry, American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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Childhood schizophrenia. Early and late gray matter deficits in schizophrenia. Areas of gray matter loss, shown in red and yellow, spread from back-to-front (right to left) over 5 years in composite MRI scan data from 12 teens with childhood-onset schizophrenia, beginning at age 14 (left). Red and yellow denotes areas of greater loss. Source: Paul Thompson, MD, UCLA, Laboratory of Neuroimaging. NIMH media file.
Childhood schizophrenia. Rate of gray matter loss. Composite MRI scan data showing areas of gray matter loss over 5 years, comparing 12 normal teens (left) and 12 teens with childhood-onset schizophrenia. Red and yellow denotes areas of greater loss. Front of brain is at left. Source: Paul Thompson, MD, UCLA, Laboratory of Neuroimaging. NIMH media file.
 
 
 
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