Schizophrenia in children and adolescents, or early-onset schizophrenia (EOS), poses diagnostic and treatment challenges. Childhood-onset schizophrenia occurs before age 13, while EOS appears between ages 13 and 18. EOS often involves social withdrawal, academic struggles, hallucinations, and thought disturbances. Comprehensive assessment, including history-taking, mental state evaluation, and ruling out medical causes, is essential. Treatment involves antipsychotics as first-line therapy, supported by psychosocial interventions like family education and cognitive-behavioral therapy, tailored to individual and family needs.

Management progresses through acute, stabilization, and maintenance phases. The acute phase prioritizes controlling psychotic symptoms, stabilization focuses on remission and relapse prevention, and maintenance aims to improve functioning and quality of life. Long-term antipsychotic use is customized to relapse history, with monitoring for side effects like metabolic issues. Psychosocial interventions, including vocational rehabilitation and educational reintegration, are vital. Early relapse recognition and intervention are critical for better outcomes, with treatment plans adapted to cultural and resource-specific contexts.

Reference: Grover S, Avasthi A. Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents. Indian J Psychiatry. 2019;61(Suppl 2):277-293. doi: 10.4103/psychiatry.IndianJPsychiatry_556_18.