- Signs of a mind in danger—including social deficits, impaired body sensations and reduced tolerance to stress—may show up anywhere from two months to 35 years before schizophrenia strikes.
- The prevalence of schizophrenia is 1.1 percent, but if a parent has the disorder, the child has a 10 to 12 percent increased risk and a 17.1 percent chance of developing a related personality disorder.
- Physical abuse, bullying by peers and ingesting cannabis can push a genetically vulnerable child toward psychosis.
From the moment he was handed to me in the delivery room, Alex, my firstborn, seemed not happy to be here. His eyes were bottomless, his expression grave. He spent his first three months writhing and screaming inconsolably, the word “colic” wholly insufficient to describe our collective suffering. It wasn’t until his brother, Sammy, arrived that I realized just how different Alex was compared with other babies. Sammy cried only when he was hungry or wet. He made easy eye contact and loved to be stroked, hugged and kissed—all the things Alex recoiled from as an infant.
Later, when I took Alex to playgroups, he crawled away from the other toddlers to do his own thing, so we quit going. It wasn’t that Alex appeared unhappy. He would sometimes sit and smile with satisfaction for no apparent reason. At age two and three, Alex attended a Montessori preschool. Although he enjoyed the hands-on activities, his teachers often commented that he usually ignored them as well as the other children. His first grade teacher thought he must be hard of hearing because he routinely ignored her directions, especially the daily reading and writing drills she assigned. In one of the first studies ever done with families afflicted with schizophrenia, the Edinburgh High Risk Study, Scottish mothers commonly described children who went on to develop the disorder as occupying a world of their own.
I had so often thought of Alex the same way.
Alex first began to manifest the so-called negative symptoms of schizophrenia in puberty. These included a loss of motivation, social and emotional withdrawal, a disinterest in hygiene and dress, and trouble sleeping. The term “positive symptoms” refers to the more obvious behaviors we think of as “crazy”—hearing or seeing someone who is not there, for example, or holding fixed, illogical beliefs—and they would unfortunately come, too, a little later, as they are known to, right before the first psychotic break.
Knowledge of schizophrenia as a long-term disease process has existed since the early 20th century. The initial signs of this process—the impaired body sensations, reduced tolerance to stress, increased emotional reactivity and, especially, social deficits—“can appear more or less continuously between two months and 35 years prior to their progression to the first psychiatric symptoms,” wrote German researcher Joachim Klosterkötter of the University of Cologne in a 2001 essay.
Although much of the profession still focuses on the debilitating full-blown illness, paying attention to its origins and early stages provides the greatest chance of altering its course. In particular, adjusting a child’s environment is one important way of minimizing the impact of this serious mental illness. Parenting does not cause schizophrenia, at least not on its own, but that does not mean that parents and other adults are powerless to protect children from it.
Weighing the Chances
In an 1896 treatise German physician Emil Kraepelin observed that many of the children of his schizophrenic patients, especially those who would go on to develop the disease themselves, were “a little different in character and behavior from their peers—beginning in early childhood.” The accumulating evidence now backs up Kraepelin’s observation that a significant number of individuals later diagnosed with schizophrenia display some common and often peculiar traits and experiences as children or adolescents.
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