Schizophrenia | Diagnosis & Treatments

How do we diagnose schizophrenia?

A mental health clinician (typically a child and adolescent psychiatrist) will make the diagnosis following a comprehensive evaluation with you and your child. During the assessment, we’ll ask you to describe your child’s symptoms and provide an overview of your child’s family history, medical history, school life, and social interactions.

Typically, a child is diagnosed with schizophrenia if he or she:

  • displays positive or negative symptoms for a period of at least one month
  • is experiencing a worsening decrease in the ability to function on a day-to-day basis

If my child is diagnosed with schizophrenia, what happens next?

Your clinician will explain the particulars of schizophrenia, including its possible causes and effects and long-term repercussions. Specifically, you will be given a thorough overview of your child's individual symptoms and prognosis.

The next step is developing a mutually agreed-upon treatment plan — incorporating psychotherapy, medication, and school and community support — that works for you, your child, and your family.

You and your child (if old enough) will always have the opportunity to ask questions. Throughout the duration of treatment, you will be encouraged to bring up any and all concerns, worries, and fears so that the clinical team can provide the information and support you need.

How do we treat schizophrenia?

Schizophrenia is a major psychiatric illness that calls for careful, often complex, and lifelong treatment. A combination of therapies is usually necessary to effectively manage the disease.

Since there is no known cure for schizophrenia, treatment is aimed at reducing the severity of the disorder's impact on early life and helping the child manage symptoms. Treatment is most successful when symptoms are addressed early on.

As one of the largest pediatric psychiatric services in New England, Boston Children's has an experienced team of expert psychiatrists, psychologists, and social workers ready to help you, your child, and your family cope. Your clinician will prescribe treatment methods that may include medication, psychotherapy, specialized educational or activity programs, and support groups.

Medication

The use of medications (also called psychopharmacology) is essential in treating schizophrenia. The most commonly prescribed schizophrenia drugs are neuroleptics, or antipsychotic medications. These drugs act against the symptoms of schizophrenia, but cannot cure the disease itself.

Neuroleptics:

  • are primarily used to treat the pervasive, intrusive, and disturbing thoughts caused by schizophrenia
  • are designed to minimize the severity of hallucinations and delusions
  • must be taken exactly as prescribed
  • may require adjustments of dosage or type over time to maintain their effectiveness

Traditionally prescribed neuroleptics include:

  • Stelazine (Trifluoperazine)
  • Flupenthixol (Fluanxol)
  • Loxapine (Loxapac, Loxitane)
  • Perphenazine (Etrafon, Trilafon)
  • Chlorpromazine (Thorazine)
  • Haldol (Haloperidol)
  • Prolixin (Fluphenazine Decanoate, Modecate, Permitil)

Newer and less commonly prescribed medications that have proven effective in treating symptoms of schizophrenia include:

  • Aripiprazole (Abilify)
  • Clozaril (clozapine)
  • Geodon (ziprasidone)
  • Risperdal (resperidone)
  • Seroquel (Quetiapine)
  • Zyprexa (olanzapine)

We have a specialized Psychopharmacology Program whose team members work with other Department of Psychiatry and Behavioral Sciences clinicians — and with parents and family members — to determine the best medications for each child, incorporate the medication regimen into the child's overall treatment plan, and monitor the effectiveness of the drugs over the long term.

Learn more about psychiatric medications for children and adolescents.

Psychotherapy

Psychotherapy — also known as “talk therapy” — is the cornerstone of psychiatric treatment at Boston Children's.

Through sessions with a psychiatrist or psychologist, your child can better:

  • understand the symptoms of schizophrenia and how to manage them
  • vocalize feelings of anxiety, fear, sadness, and anger associated with having a chronic psychiatric condition
  • develop coping skills for the challenges of daily life
  • deal with the stigma of mental illness
  • explain schizophrenia to questioning family members and friends
  • learn new ways to maintain healthy relationships with parents, siblings, teachers, and peers
  • recognize the importance of adhering to a treatment plan, as well as setting goals and looking forward to the benefits of proper treatment

Treatment for schizophrenia will often include not only individual therapy for your child, but also family therapy for you and other loved ones, so that you have the information, support system, and other tools you need to become an active participant in your child's care.

Specialized educational and/or structured activity programs

Children and adolescents with schizophrenia may reap significant benefits from specialized programs offered at schools, in medical centers, or in the community. Examples of these programs might include:

  • customized, smaller classroom settings, with educators who have specialized training in teaching children and adolescents with psychiatric disorders
  • social skills training to:
    • develop healthy personal interaction techniques (such as maintaining good eye contact and determining fitting topics of conversation)
    • create a checklist for good hygiene
    • learn how to manage everyday tasks like balancing a checkbook or preparing a meal
  • vocational training to help young adults find jobs and volunteer opportunities
  • speech and language therapy to improve verbal and written communication

Your clinician can refer you to the educational and activity programs in your area that are best suited to address your child's needs.

Support groups

Schizophrenia support groups for children and families can be tremendously helpful. These groups meet at medical centers, schools, or community centers, and some even meet online or by phone. These resources can provide:

  • a “safe place” to share personal experiences and simply “vent” when necessary
  • a way to share tips and coping strategies with others facing the same challenges
  • a network for identifying and recommending local resources

Your treatment team can recommend patient, parent, sibling, and family support groups that focus on living with schizophrenia.

Coping and support

The journey you, your child, and your family will undertake in treating schizophrenia can be emotionally, physically, and mentally exhausting.

In addition to the information provided here, Children's offers the following resources for support and guidance:

  • The Hale Family Center for Families is dedicated to helping families locate the information and resources they need to better understand their child's particular condition and take part in their care. All patients, families, and health professionals are welcome to use the center's services at no extra cost. The center is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
  • The Department of Spiritual Care (chaplaincy) is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members — representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian, and United Church of Christ traditions — who will listen to you, pray with you, and help you observe your own faith practices during your child's treatment.
  • The Experience Journal was designed by psychiatrist-in-chief David DeMaso, MD, and members of his team. This online collection features thoughts, reflections, and advice from kids and caregivers dealing not only with physical illnesses like asthma and diabetes, but also with such mental health conditions as ADHD and depression.

Visit our patient resources page for all the information you need about:

  • getting to Boston Children's
  • finding accommodations
  • navigating the hospital experience

Helpful links

Please note that neither Boston Children's Hospital nor the Department of Psychiatry and Behavioral Sciences unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.

Helpful links for parents

Helpful links for teens

Helpful links for younger children