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It's been a rough week. A few days ago, at UCLA's Resnick Neuropsychiatric Hospital, 6-year-old Jani toppled a food cart and was confined to her room. She slammed her head against the floor, opening a bloody cut that sent her into hysterics. Later, she kicked the hospital therapy dog.
Jani normally likes animals. But most of her animal friends -- cats, rats, dogs and birds -- are phantoms that only she can see. January Schofield has schizophrenia. Potent psychiatric drugs -- in doses that would stagger most adults -- seem to skip off her. She is among the rarest of the rare: a child seemingly born mentally ill.
She suffers from delusions, hallucinations and paroxysms of rage so severe that not even her parents feel safe. She's threatened to climb into an oven. She's kicked and tried to bite her little brother. "I'm Jani, and I have a cat named Emily 54," she says, by way of introduction. "And I'm Saturn-the-Rat's baby sitter."
She locks her fingers in front of her chest and flexes her wrists furiously, a tic that surfaces when she's anxious.
She announces that she wants to be a veterinarian.
"I'm empathetic with rats," she says.
Asked what "empathetic" means, she smiles confidently. "It means you like rats."
The doctors have been trying a new antipsychotic medication, called Moban. Jani knows she is sick and that people want to help her.
"Is the Moban working?" her mother asks Jani during a visit.
"No. I have more friends."
Susan Schofield looks crestfallen.
She and her husband, Michael Schofield, have brought French fries. Jani takes a bite, runs around the room and circles back for another bite.
"You want the rats and cats to go away, don't you?" Susan asks, trying to make eye contact with her daughter.
Jani stuffs a French fry into her mouth.
"No," she says. "They're cool. Rats are cool."
--
About 1% of adults have schizophrenia; most become ill in their late teens or 20s. Approximately one in 10 will commit suicide.
Doctors and other mental health experts don't fully understand the disease, which has no cure. Jani's extreme early onset has left them almost helpless. The rate of onset in children 13 and under is about one in 30,000 to 50,000. In a national study of 110 children, only one was diagnosed as young as age 6.
"Child-onset schizophrenia is 20 to 30 times more severe than adult-onset schizophrenia," says Dr. Nitin Gogtay, a neurologist at the National Institute of Mental Health who helps direct the children's study, the largest such study in the world on the illness.
"Ninety-five percent of the time they are awake these kids are actively hallucinating," Gogtay says. "I don't think I've seen anything more devastating in all of medicine."
Jani normally likes animals. But most of her animal friends -- cats, rats, dogs and birds -- are phantoms that only she can see. January Schofield has schizophrenia. Potent psychiatric drugs -- in doses that would stagger most adults -- seem to skip off her. She is among the rarest of the rare: a child seemingly born mentally ill.
She suffers from delusions, hallucinations and paroxysms of rage so severe that not even her parents feel safe. She's threatened to climb into an oven. She's kicked and tried to bite her little brother. "I'm Jani, and I have a cat named Emily 54," she says, by way of introduction. "And I'm Saturn-the-Rat's baby sitter."
She locks her fingers in front of her chest and flexes her wrists furiously, a tic that surfaces when she's anxious.
She announces that she wants to be a veterinarian.
"I'm empathetic with rats," she says.
Asked what "empathetic" means, she smiles confidently. "It means you like rats."
The doctors have been trying a new antipsychotic medication, called Moban. Jani knows she is sick and that people want to help her.
"Is the Moban working?" her mother asks Jani during a visit.
"No. I have more friends."
Susan Schofield looks crestfallen.
She and her husband, Michael Schofield, have brought French fries. Jani takes a bite, runs around the room and circles back for another bite.
"You want the rats and cats to go away, don't you?" Susan asks, trying to make eye contact with her daughter.
Jani stuffs a French fry into her mouth.
"No," she says. "They're cool. Rats are cool."
--
About 1% of adults have schizophrenia; most become ill in their late teens or 20s. Approximately one in 10 will commit suicide.
Doctors and other mental health experts don't fully understand the disease, which has no cure. Jani's extreme early onset has left them almost helpless. The rate of onset in children 13 and under is about one in 30,000 to 50,000. In a national study of 110 children, only one was diagnosed as young as age 6.
"Child-onset schizophrenia is 20 to 30 times more severe than adult-onset schizophrenia," says Dr. Nitin Gogtay, a neurologist at the National Institute of Mental Health who helps direct the children's study, the largest such study in the world on the illness.
"Ninety-five percent of the time they are awake these kids are actively hallucinating," Gogtay says. "I don't think I've seen anything more devastating in all of medicine."
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Also, it is typical for many sufferers to be absorbed in their hallucinations, this is just how the disease affects the brain, it causes a lot of 'self referencing' thoughts - focusing on one's internal stimulation instead of others around him (or her). Since medication doesn't always control all symptoms, therapy is centered around teaching people to ignore their symptoms, and to function as well as possible despite their symptoms. Instead of being upset or frightened by symptoms, those around the person need to work hard to immediately reward and encourage the sufferer to pay attention to other things. For example, while it's good for children to describe their hallucinations freely and openly, it's also very important to redirect them and reward them. A person can say, 'ok, rats are cool, thanks, now what did you have for breakfast, young lady?' Refocus away from the symptoms and reward it every single time the child does something inspite of the symptoms.
tusu (01/13/2010, 3:48 AM )