What we know about the pathology of schizophrenia indicates no outstanding difference between the illness that strikes in adolescence and the illness that strikes in adulthood.

There may, however, be a difference in severity of symptoms. When the disease strikes early, patients tend to have:

• More severe brain abnormalities present before diagnosis

• More abnormalities in brain cells

• Poorer future outcome

• Possibly a greater genetic burden based on their relatives who have or have had psychiatric illnesses

If symptoms are present early, they may not appear particularly startling on their own. Not all children who go on to develop schizophrenia stand out as different in their behavior.

When considered in retrospect, the behavior of children later diagnosed with schizophrenia, may seem “different.” From a very early age, they may have been less social and more emotionally distant than other children. Looking back after full-blown schizophrenia has developed, these symptoms are often recognized as the beginning of a decline in functioning.

Danger! Decline in Intellectual Functioning

Adolescence is often a challenging time for young people and their parents. Passage through normal adjustment periods can be frustrating and aggravating for both parent and child.

While some early warning signs of mental illness and prodromal signs of schizophrenia may have alternative explanations, there is one that usually does not. When a young person shows a decline in his intellectual or thinking abilities, a psychiatrist will begin to suspect schizophrenia. A loss in cognitive ability in a young adult is rare unless schizophrenia is involved.

This doesn't mean one or two bad grades. It means a pattern of problems that indicate a young person cannot understand, read, write, or think as well as she once could. You should seek professional advice if you detect such cognitive dysfunction in a young person.

School Problems Due to Cognitive Problems

A 2008 study of more than 900,000 Swedish children born between 1973 and 1983 found that students who received the lowest scores on standard tests had double the risk of being diagnosed with schizophrenia later in life. Those with the worst performance records in all areas of schoolwork had four times the normal risk of developing the disorder. The medical records of the children, who were 15 or 16 years old when they took the tests, were examined when the subjects were 17 or older.

The researchers who conducted the study do not believe that lack of intelligence explains the observation. For these children, the researchers believe, it is likely that their poor performance was a consequence of cognitive problems.

One of the authors of the Swedish study, Dr. James MacCabe of the Institute of Psychiatry at King's College London, was quoted by the BBC: “Doing badly at school is not a cause of schizophrenia, but it is a marker for something not being quite right several years prior to diagnosis.”