Unravelling schizophrenia in teenagers – Fourways Review

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While it can be distressing for the whole family when their teenager suffers from a psychiatric condition, developing an understanding of the condition and its treatment can help to better equip parents to support their child’s mental well-being.

We chat with Dr Ulli Meys, a psychiatrist who specialises in adolescent mental health for more on the subject of schizophrenia in teens.

Diagnosing a psychiatric condition

“Diagnosis of a psychiatric condition is often complex, and it can be even more so in adolescents,” notes Dr Meys.

“This is the life stage where they are developing their own identity, distinct from their family unit, and young adults are beginning to express their character or personality. This can often be a stressful transition, especially as it coincides with a time when many young people are tempted to experiment with drugs or alcohol.”

What are the signs and symptoms?

Where a person in their late teens develops psychosis, which is defined as a state where the individual loses touch with reality and may experience hallucinations or delusions, this could be an indication of schizophrenia. In the short-term, this can be difficult to distinguish from toxic psychosis, which is a reaction to drugs, alcohol, or even certain medication.

Psychosis commonly involves the individual experiencing delusions that they are either being persecuted or watched and is accompanied by paranoia, or where they have delusions of grandeur, and the individual believes they have special powers or influence.

“To differentiate between psychosis brought on by schizophrenia and toxic psychosis, we would look at several factors,” says Dr Meys.

“Schizophrenia has a strong genetic link, and establishing whether there is a family history of schizophrenia would be an important factor to consider. The family may also be able to describe whether the change in the teenager’s mental state occurred suddenly or over a number of weeks, and whether there is a known history of association with drugs.”

Predisposed schizophrenia

Where the psychotic episode is linked to schizophrenia, a gradual change may be observable over weeks or months with the person behaving increasingly out of character, as opposed to toxic psychosis where the onset is sudden and marked. While substance abuse may point to toxic psychosis, it should be noted that using recreational drugs such as cannabis often triggers the onset of schizophrenia in those who are predisposed.

In most instances, the effects of toxic psychosis will wear off in a few days to a few weeks, whereas delusions related to schizophrenia do not resolve themselves and tend to deepen over time.

How is schizophrenia managed?

Schizophrenia can usually be managed with medication, but psychiatric medication for adolescents should only be prescribed by a specialist psychiatrist in specific circumstances, following a thorough assessment.

Without the appropriate psychiatric treatment, schizophrenia will be likely to escalate, and it is therefore really important to ensure an accurate diagnosis, bearing in mind that this condition has symptoms that may overlap with other disorders and present similarly.

The importance of continuing treatment

An important part of the treatment of schizophrenia is educating the individual concerned and their family about the condition, and the importance of managing it on an ongoing basis.

“It is a common misperception that once the individual feels better, there is no need to continue with psychiatric medication. In fact, this is an indication that the medication is working and, unless the treating psychiatrist advises otherwise, the person should continue taking their prescribed medicine on an ongoing basis or risk a relapse,” Dr Meys concludes.  

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