13 Most Essential Data-Points In #PizzaGate Pedophilia Allegations

Posted by Ryan Cristián For The Last American Vegabond By now, the disturbing story of #Pizzagate and its ongoing investigation is spreading like wildfire. Unfortunately many have yet to catch wind of exactly what the most essential pieces to this story are, the most important characters, and the implications involved. As usual, mainstream media is either blackballing it entirely, or writing propagandized “hit pieces ” on the matter, implying their attempt to slander the evidence and to sway others from looking deeper into it with an open mind. Even the New York Times did a “fact check” on it, claiming it to be false despite not presenting any information that researchers have unearthed online, or even bothering to explain why said research was deemed untrue. There was also an older, unrelated story titled “Pizzagate” that has since resurfaced, and has nothing to do with the current investigation. Other than showing the obfuscation that is occurring during the Pizzagate investigation, this also goes to show how played-out and outdated this whole, “Watergate” colloquialism has become. The tactlessness of the title andits trivial vernacular, however, do not diminish the gravity and depravity of the research at hand. To transmute this mercury a bit, so to speak, The Last American Vagabond will attempt to plot out the quintessential points brought up by the anonymous researchers piecing it all together online. Hopefully, newcomers can get up to speed and decide for themselves what’s real and what’s not, as law enforcement and mainstream media are clearly failing to do their due diligence. This is not meant to directly slander anyone/place or preemptively accuse anyone of guilt, but instead is designed to simply provide the data and the links between different threads of research, so that others can understand the investigation easier. A fair and open trial is the endgame being sought by the collective investigating community—but to even get a trial and proper investigation with deeper resources, there must be enough evidence and public support to make an arrest, especially considering the high-profile people implicated. Additionally, while The Last American Vagabond is merely attempting to provide a road-map of Pizzagate without the aforementioned accusations, it should be emphatically noted that the evidence involved here not only seems to be more than enough to merit the attention of our researchers, but the circumstantial evidence involved in this investigation, by both logically empirical and lawful standards, more than warrants a full investigation into these matters. This will not be quick, and the reader will not enjoy this. It is incredibly difficult and unsettling to read, but it is paramount that the people fully understand what is taking place here. The hard truth grinding away at the reader’s teeth, and tensing up in their chest, confusing their thought process, is the harsh potential of the thousands upon thousands (god forbid, millions) of innocent children who spend their youth circulating through these sado-occultist pedophilic smuggling rings , only to be tossed into the streets after their youth has aged away. Anyone who feels strongly about the subject has a moral obligation to share this with others, as justice will only be found with numbers. Nobody should have these disturbing facts force-fed tothem, but it is imperative that those who would care, should care, and they will not care if they have not heard about it. Here is a good video summary before diving deeper. Here is an infographic chart that can be referenced in order to see the various links between the different threads and data points. There will also be plenty of links that are either hyperlinked in or sourced below for people to go about their own research on the topic, which is highly recommended before any opinions are formed. This is still an ongoing investigation and all hands are needed on deck, and there have been numerous problems with entire open-source investigation forums being deleted (sometimes with warning, sometimes without), with all research lost that has not been saved by individuals. There are many more threads that are not even mentioned here such as probability of the underground tunnels meant for smuggling and containing childrenbeneath these suspected venues (a recurring theme in the history of research into this pedophilic smuggling ring—something most directly noted by the McMartin Pre-School Scandal of the late ‘80s), Huma Abedin’s connections to Saudi Arabia and their possible connections to child pedophilia, and Anthony’s Weiner’s connection , Rachel Chandler, the bizarre business named “Buck’s Fishing and Camping, ” among many other interesting threads. The reality is that there is only so much data that can be reasonably covered here. 1) Past History Of High Profile Child Pedophilia Cases Before assessing the specifics of Pizzagate, it is important to first understand that there have been many high-profile cases of child pedophilia, as well as satanic occult rituals at the upper echelons of power before the current Pizzagate scandal even broke out—most important, it is crucial to note that these cases of pedophilic smuggling rings have never surfaced without heavy affiliations to occultism, and are often heavily linked to drug smuggling . Some of the most prevalent cases are documented in a previous articleposted The Last American Vagabond , which include the Dutroux Affair, the Franklin Scandal, the Presidio Military Base Abuse, the False Memories Syndrome Foundation, the McMartin Preschool Abuse, and The Finders Scandal. This article has plenty of links for those who wish to investigate on their own and further understand the details/extent of these cases. For a less extensive look at individual cases, and more of an over-arching analysis, the article below is a good starting point: Related Reading: American Pedophilia: Prerequisite of a Wealthy Elitist As with any research, this is only the tip of the iceberg, as many other people and institutions are involved in the disturbing practice of child pedophilia and smuggling. Some prominent people involved include famous media mogul Jimmy Savile (who socialized with Royalty and was knighted by both the Queen and the Pope); the Penn State Assistant Football Coach Jerry Sandusky ; and elite financial investment mogul Jeffrey Epstein , who is discussed in more detail below. There are also high-profile cultures like Hollywood and the Vatican , and implications even from WestPoint Academy, which have been the centerpiece of various cases involving child pedophilia. Some of this has come to light through court cases and researchers, while other claims have come through controversial whistleblowers such as Cathy O’Brien , and even outspoken Hollywood stars like Corey Feldman and Elijah Wood . Both stars have discussed the realities of a deep undercurrent of pedophilic child smuggling at the highest levels of Hollywood. 2) Comet Ping Pong One of the epicenters of the investigation has to do with pizzeria in Washington DC called “Comet Ping Pong .” The owner of this pizza place is James Alefantis, who happened to be ranked #49 in the top 50 “Most Powerful People in Washington” of GQ magazine. His ex-boyfriend, David Brock , is the founder of the liberal media watchdog group “Media Matters For America ” and the Pro Hillary super Pac, Correct The Record (CTR). Brock also has been described by Time magazine as “one of the most influential operatives in the Democratic Party .” Interestingly, the infamous George Soros has contributed sizable amounts of funds to PAC’s chaired by James Alefantis; Soros is also a major financier of Media Matters. Alefantis and Brock, for what it’s worth, also seem to be caught insome mysterious blackmail love triangle that has embroiled them prior to the Pizzagate allegations. Comet Ping Pong itself is interesting for a variety of reasons. Firstly, many prominent democrats have held fundraisers there such as Hillary Clinton and Barrack Obama , which is odd considering it’s just some small pizza shop and supposedly a family location that is child-friendly. This sparked further research, which lead to the discovery of the Comet Ping Pong Instagram page , which has some incredibly strange pictures andcomments that are highly suggestive of child pedophilia as well as torture rooms and hidden chambers hidden beneath this area (abandoned subway tunnels have been reportedly confirmed beneath the area, and reports have also claimed that Comet Ping Pong has not had a building permit in over three years, meaning that there is likely no official record of any renovations of this type done). The account has since been set to private, but many of the pictures were archived by researchers. There is also a lot of strange artwork on the wall at Comet Ping Pong and equally weird flyers for concerts that have strong sexual themes , grotesque vulgarity and overtoccultism , which again is very weird for a place that is supposedly suitable for children and boasts an “All Ages” claim underneath the artwork on these flyers. Many of these concerts start late at night and serve alcohol, yet claim they are suitable for all ages. Some other points of interest include Majestic Ape (Amanda Klienman ), who regularly performs there, yet has references to child pedophilia in her songs. There are also pedophile symbols in Comet Ping pong’s menu brochures, which seem to match the same pedophile symbols outlined by the FBI . Independent journalist, Jack Posobiec, decided to go investigate both Comet Ping Pong and Besta Pizza (discussed ahead) by periscoping his dinner there with his smart-phone, yet was promptly kicked out by the police. His description of what happened is quite telling and can be viewed here . Finally, there are hidden bathrooms in the Comet Ping Pong as well as amysterious backroom, which is often pointed out by yelp customers as quite strange. The overwhelming amount of circumstantial evidence raises an aura of peculiarity and suspicion, but no direct proof of anything nefarious has been found in this pizza joint. The real dirt is found online, and between the connections of the characters involved in this story. 3) Coded Language In The Podesta Emails Leaked By WikiLeaks The heart of the Pizzagate research essentially stemmed from the Podesta emails released by WikiLeaks. Due to the tireless reporting during the (s)Election Cycle of these emails, they were scoured by independent researchers and collaboratively discussed online. As a minor note of interest, due to this connection to the (s)Election hype, there are small but notable elements of independent Trump support who have been instrumental in promulgating this research, which was readily welcomed because of their heavy anti-Clinton stance. Pouring through these emails, researchers online found high level politicians fancied Comet Ping Pong as a successful political fundraiser venue. Odd as that is, collaborative researchers began deeply researching Comet Ping Pong, Besta Pizza, et cetera, stumbling across their Instagram accounts and much more … and the rest is becoming history. Meanwhile, as people investigated the details involving the physical locations, researchers began analyzing the absolute nonsense that was found throughout any and all emails related to Comet Ping Pong. This section here can only remain as a summary, but suffice it to say that when these emails are poured through one by one, it becomes absolutely clear that these food-related words are code language, and this directly implies by proxy that Comet Ping Pong and likely Besta Pizza are indeed fronts for something. If all of the language used by politicians surrounding these joints is code, then it seems an entirely logical point of investigation—if nothing more. Surely, these people can’t be so desperate to “make a pizza” for one another when they are all busy moguls of one sort or another. Why would grown men and women be so continuously and excitedly emailing and promptly responding amongst each other about “cooking” and “eating” all sorts of very basic “foods.” One of the primary indications that something strange was occurring here, was the “cooking” relationship to Marina Abramavic’s “spirit cooking” “art” rituals (see section 8). Firstly, anyone who is a true occultist will tell you that art is exclusively an expression of metaphysical archetypal concepts, and that any good magician uses their art to further their magick. This is a basic tenet that has been discussed by occultists since occultists have been discussingthings. When these people casually laugh off these theories because they were “just performing art,” they are denying the truth by obfuscation, and admitting it at the same time. The discovered coded language used within the Podesta emails appears to be one used exclusively by known pedophiles. This code uses food items such as “pasta” “cheese pizza”, and “ice cream,” to refer to child pedophilia. They also appear to be talking in handkerchief code, which is even listed in Wikipedia as a coded color system for sex, mostly stemming from underground homosexual movements in the 1970’s. Symbology is admittedly a slippery-slope, and it is recommended that one be educated in the subject when deciphering symbols and their context. Of course, the researchers very well may have been educated in symbolism since they are mainly anonymous users online, and there is also a lot of discussion of FBI-insiders collaborating on the research—angry at their lack of results going after Clinton. Regardless, the correlation is apparent. As a final point of consideration on this data point, remember that the symbol of the “pizza” has become iconic in this case due to the FBI’s known list of pedophiliac communication symbology. Case in point, Besta Pizza’s sign is accused of being a calling card that is identical of the FBI’s “Boy Lover” logo , being a triangle with a specific style of squiggle(a little ironic that triangles are the center of all this…). Comet Ping Pong’s gimmick of having “ping pong tables in the basement” has also been suggested to be symbolic of “playing” with the children that may or may not be literally kept in the basement. Here is the circulated list of the alleged “code words.” Despite pizza being reminiscent of the “Little Boy Lover” symbol, “hotdog” is the dialectic code for “boy” and “pizza” is the code for “girl,” for grotesque reasons of biological observation. “hotdog” = boy “pizza” = girl “cheese” = little girl “pasta” = little boy “ice cream” = male prostitute “walnut” = person of color “map” = semen “sauce” = orgy Here are a couple emails that are in question using this code: https://wikileaks.org/podesta-emails/emailid/19018 “I consider ice cream, its purchase, and its consumption a rather serious business. We can’t just willy-nilly toss it out and about in casual references, especially linked with the word ‘free’.” https://wikileaks.org/podesta-emails/emailid/30613 “Lo and behold, instead of pasta and wonderful sauces, it was a lovely, tempting assortment of cheeses, Yummy. I am awaiting the return of my children and grandchildren from their holiday travels so that we can demolish them.” https://wikileaks.org/podesta-emails/emailid/32795 “Hi John, The realtor found a handkerchief (I think it has a map that seems pizza-related. Is it yours? They can send it if you want. I know you’re busy, so feel free not to respond if it’s not yours or you don’t want it .” https://wikileaks.org/podesta-emails/emailid/44232 “Thx for coming out. Always happy to babysit.” For the commonly circulated list of the emails being analyzed, taken from WikiLeaks.org , as supplied by Titus Frost, click here . 4) Jeffrey Epstein Jeffrey Epstein is a billionaire financier who is a registered sex offender after being found guilty for soliciting prostitution from girls as young as 14. He is the owner of a private island near St. Thomas in the U.S. Virgin Islands called Little St. James, which many now refer to as “Orgy Island.” The island is said to house girls as sex slaves in order to please the many famous visitors that come to the island for a disturbing sort of “exotic getaway.” There is also a bizarre temple located on his island that seems to have the occult symbolism representing Moloch , which is the same occult symbol that is worshipped during mock sacrifices at the Bohemian Grove ceremony. One of the most famous visitors to the island was Bill Clinton , who is said to have ditched the secret service at least 26 times to ride on Epstein’s private jet, often referred to as the LolitaExpress. There have been several other prominent names connected to Jeffrey Epstein, such as Prince Andrew, Donald Trump , and Alan Dershowitz. He is quite the man of mystery and is said to only take on clients with at least one billion dollars in net worth. Here is a good video outlining the case against Jeffrey Epstein as reported on by Ben Swann . Suffice it to say thathis operation seems to run far deeper than most realize. 5) The Podestas By now, most people are aware of the recent truths that have come to light about the corruption of the Clintons and their foundation due to the leaked emails released by WikiLeaks belonging to John Podesta , the chairman of Hillary Clinton’s 2016 campaign. Points of interest concerning John Podesta (besides his deep connections seen plainly in the emails) is that he held a fundraiser at Comet Ping pong for President Obama; was also the Chief of Staff for Bill Clinton; and joined in on the “spirit cooking” with Marina Abramovic numerous times. He is also an extremely connected insider, as exposed in Abby Martin’s latest “Empire Files” report ,for those seeking more information on him and his brother. Next, there is his brother, Tony Podesta , a hyper-connected and immensely powerful DC lobbyist, who is also quite the collector of some very dark and suggestive art work that clearly references some form of child abuse, seemingly child pedophilia, and also seems to directly reference the likes of Jeffrey Dahmer. There is even an article in the “Washington Life” of guests going to his house and being absolutely shocked and disgusted by what they saw. Tony Podesta is also very fond of thelesser-known artist by the name of Bilijana Bjurdevic , and judging by his art, has some very disturbingly overt images of what can only be considered the beginnings of child sacrifice and torture. It is heavily speculated that Bjurdevic was one of Tony Podesta’s favorite children to abuse, and is thus a survivor of this pedophile ring. Tony Podesta is also friends with convicted pedophile and former House Speaker, Dennis Hastert. Podesta and Hastert did a 3-4 month trip to Japan for the People to People Student Ambassador Program and, according to leaked WikiLeaks emails, they still keep in contact despite Hastert’s heinous convictions. Tony is also rumored to hold his birthday party at Comet Ping Pong of all places. 6) The Clintons It should be no surprise to anyone doing any type of independent investigative work that the Clintons would be potentially involved in something like this. They are tied to all the big players in the investigation either directly, through their foundation, or indirectly through people they associate with. To begin with, their campaign manager is/was John Podesta, they are close friends with pedophile Jeffrey Epstein , who has claimed he co-founded the Clinton Foundation , and they have a close relationship with Marina Abramovic. This iscoupled with the fact that Bill Clinton has been accused of rape numerous times and whistleblower Cathy O’Brien has accused both Clintons of abusing her, although no prosecution has taken place. This also comes with the added context that the Clinton Foundation has been exposed as being highly corrupt and involved in a “pay-to-play operation ” that helps cement aspects of insider politics, which seems to be pointing to a further operation of blackmail pedophilia and child sex trafficking. They also have very close connections to Saudi Arabia , which is also known to have its own issues with child pedophilia at the highest levels of power. Furthermore, FBI whistleblower, Sibel Edmonds, has discussed in detail her allegations of Bill Clinton’s “COINTELPRO II,” which was said to be his attempt to dig up dirt on surrounding politicians in order to keep himself afloat during his own scandals. In short, this could mean that the Clintons are involved with the collection of this evidentiary material in order to blackmail those politicians who step out of line with Globalist agendas . As a final note for this data point, the “Beyond Borders” Clinton foundation’s building sits right across from Comet Ping Pong. 7) Besta Pizza Another pizza place that is in question is “Besta Pizza,” which is located right next to “Comet Ping Pong” and owned by Andrew Kline. One of the main reasons researchers initially became suspicious is due to it’s logo’s disturbing homage to what the FBI associates as an official pedophiliac symbol used for communication between insiders. Especially telling, is that Besta Pizza recently changed their logo , once researchers caught on to it. However, the connections continued to be made, and it is now known that Andrew Kline knows John Podesta; is “one of four attorneys in the Human Trafficking Prosecution Unit of the Department of Justice, in the Civil Rights Division;” and is a Clintonappointee. 8) Spirit Cooking and Marina Abramovic One of the initial disturbing finds in this collaborative investigation was the “art performance” of “Spirit Cooking,” that has been enjoyed by the Podestas, Alefantis, and even the Clintons. “Spirit Cooking” is the performance of the witch, Marina Abramovic, and is “inspired” by occult sacrament ritual stemming from Aleister Crowley’s Enochian-inspired doctrine of Thelema, which has been loosely categorized as “sex magick,” which is often coupled with traditional Tantra in certain senses. However, while Thelema in and of itself is not inherently evil, Thelema has been historically used for much more dark occultism/black magick than Tantra(although some would likely contest this point). This sacramental aspect is the consideration of human bodily fluids being charged with a specified metaphysical energy and/or perhaps some sort of electrical. In terms of scientific analysis, psychiatrist Wilhelm Reich was known for his practicing analytical theories of what he called “orgone energy,” which was the scientific observation of the human body as an electromagnetic conductor of sorts, channeling energy of the mental, physical and spiritual variety in a coalescence that manifested in the expression the physical body. Much like the resins of a plant being concentrated, so are the bodily fluids of the human considered by occultist to have concentrated energetic uses. While some want to claim this is just “art,” simply being misunderstood, Marina herself has been quoted saying , “If you are doing the occult magic in the context of art or in a gallery, then it is art. If you are doing it in different context, in spiritual circles or private house[sic] or on TV shows, it is not art .” So by her very own definition, this cannot be considered art. Additionally, looking at the videos of Abramovic’s “art,” it seems a rather dark practice that even entails mock cannibalism. The spirit cooking dinner in which the Clintons and many other famous guests attended (reportedly, Abramovic is close to the likes of Lady GaGa, Jay-Z, Beyonce’—go figure) was hosted by this performing artist/practicing witch, Marina Abramovic, as a dinner that served as a piece of living art. The whole thing is rather bizarre, especially considering who attended the event, and that many of those attendees are being revealed as connected to this topic. 9) Laura Silsby and Clinton-Related Child Trafficking Allegations Former director of The New Life Children’s Refuge, Laura Silsby was arrested in Haiti in 2010, for trying to smuggle 33 children across the border. Strong allegations derived from research into the WikiLeaks email data-dump suggest that none other than Hilary Clinton was very adamant about trying to politically aid Silsby during her arrest and jail time and Haiti. Strangely, most of the kids were not even orphans. Reportedly the material was originally anonymously posted to a Reddit forum and has since circulated amidst the tangled web of information surrounding Pizzagate. The original article on the subject can be read here . 10) Madeleine McCann The kidnapping of Madeleine McCann was arguably one of the most reported missing-persons cases in American History. It was broadcast worldwide and investigated out in the open for the public to see. What’s very interesting is that the police sketches of the sought after suspects thought to be involved in Madeleine’s disappearance, have a shockingly striking similarity to John and Tony Podesta . What’s even more interesting is that according to Victurus Libertas an anonymous FBI insider has confirmed that the Podesta’s were in Portugal on the day of Madeleine’s disapperance , however, this information is as of yet still not confirmed by a second source. The two brothers were also revealed to be staying at the house of Clement Freud, nephew of Sigmund Freud and a known friend of the Podestas, which is only a third of a mile from the exact location of the kidnapping. Clement Freud, who died in 2007 and was a known pedophile , was accused by at least three separate girls of molesting them while they were underage. There is a photo that has emerged that many have speculated could be Madeleine McCann playing cards next to what is clearly John Podesta, a few years after she had been kidnapped. Progressive police sketches of what Madeleine might look like at that age are unsettlingly similar. There is also a Fox news clip where they say they know who kidnappedher, but cannot prosecute them due to complications in International law, which is quite odd considering the magnitude of the case. Many are warning that this specific thread of the Pizzagate investigation might be an intentional limited hangout designed to lead independent investigators in the wrong direction, as well as give mainstream media ammo for the current media war that is underway . As possible as that may be, there is still far too much circumstantial evidence to simply ignore, regardless of the societal stature of those involved. 11) Arun Rao A man named Arun Rao was caught engaging with an outstanding number of James Alefantis’ creepy toddler Instagram posts. What’s ironic is that Arun Rao’s is the Assistant US Attorney and Department of Justice Supervisor of the Southern Division office for the DOJ’s District of Maryland. Comet Pizza is technically in Washington DC, but is practically on the border of Chevy Chase, Maryland, which is Rao’s jurisdiction. One of the tasks of his division is prosecuting those responsible for child pornography. This, of course, does not directly implicate Mr. Rao, but it’s very odd seeing an individual whose very job it is to prosecute such crimes, being one of the few actively liking the pedophilic Instagram posts of Comet Ping Pong. If these allegations are indeed true, befriending the very man charged with prosecuting such crimeswould be a protective step at the very least. 12) Death of Researcher Max Spiers More of a speculative data point, Max Spiers was an independent researcher that recently died of a mysterious “suicide” that has yet to be explained. What is interesting is that he was supposedly investigating a pedophile ring out in San Francisco right before he died. Being so close to the Pizzagate Scandal, this little piece of information should perhaps not be taken lightly. 13) TwitterGate November 21, 2016, Anonymous-affiliated “Twitter users @0hour , @Eclipse_OW , and @WonderChick were able to create scripts that tracked Twitter accounts posting child pornography and the accounts that followed them. An estimated 25,000 accounts were found related to child pornography , some of which were active for at least a year, if not longer, ” (quote taken from Reddit for its conciseness). This has become what is known as #Twittergate , which is another Anonymous “campaign.” The roots of a variety of these Anonymous campaigns are highly suspect (such as #OpCharlieHebdo, #OpWhiteRose, and their variety of campaigns against ISIS on social media) not exactly for their direct goals, but for the subtle outcomes of their campaigns, which in these cases basically resulted in promoting media propaganda and further dividing authentic activists. However, Anonymous as an identity is completely de-centralized, and literally encompasses anyone who decides to call themselves “Anon”—and any real Anonymous hacker will be the first to say that Anonymous social media is likely run on some level by Public Relations propaganda, and that many Anonymous hackers are government agents. This has been the gritty reality of hacktivism since LULZXMAS 2012. That being said, each “Anonymous” activist and campaign should be analyzed independently from one another on an initial basis, and Anonymous as a collective earns a massive “golden star of approval” for their efforts related to #Pizzagate and the affiliated #Twittergate and #OpDeathEater. Anonymous activist, Titus Frost, as well appears to be one of many instrumental characters in the initial popularization of #Pizzagate,having already put up a web documentary on the subject, and creating multiple online debates. https://steemit.com/pizzagate/@titusfrost/pizzagate-the-documentary-podesta-s-emails-lead-to-pedophilia-involving-obama-clintons-doj-and-the-dnc https://dcpizzagate.wordpress.com/ http://www.anonews.co/twittergate-twitter/ Endgame It should be fairly evident that there is an abundant and vast array of material here that was not discussed, or was only briefly mentioned, for multiple reasons. Firstly, this is meant to be as easily digestible to the reader as possible and length tends to complicate this function. Secondly, and more bluntly put: there is only so much that can be handed to the public on a platter. At some point, the citizens themselves must maintain a comprehensive self-initiative to garner any real results. This article humbly suggests that this initiative stem from one’s desire to do right by the nation’s children. Every child deserves an existence devoid of abuse and exploitation. If there is any reason to mock the conspiracy theorist —with topics ranging from UFO-chasing, Triangle-Hunting, and surveillance paranoia, et cetera—the desire to investigate the likes of a networked child pedophilia ring linked to the nation’s most prominent politicians , is certainly not the one. The person who discards this material merely as a “bunch of bologna” based on hearsay, and not their own research, is a part of the problem byproxy. If Pizzagate is even remotely true, even in the smallest regard, the public has a moral obligation to ensure and verify the safety of its youth. Pizzagate seems very much to be the beginning of this self-initiative. Despite censorship on all forums that have helped conduct this research (at this point, Reddit has banned discussions of Pizzagate ), the investigation still runs strong, and has since been adopted by the well-populated and thriving forum of James Corbett’s corbettreport.com . With the efficacy of Corbett and his community’s results with researching, it is heavily recommended that anyone who wants to engage with the Pizzagate investigative community direct themselves to corbettreport.com . Whatever be the case, let us not live in denial. http://www.thelastamericanvagabond.com/conspiracy/13-essential-data-points-pizzagate-pedophilia-allegations/ Posted by Ryan Cristián For The Last American Vegabond

Depression in Children

Can Children Really Suffer From Depression? Yes. Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. Just because a child seems sad doesn't necessarily mean he or she has significant depression. If the sadness becomes persistent, or if disruptive behavior that interferes with normal social activities, interests, schoolwork, or family life develops, it may indicate that he or she has a depressive illness. Keep in mind that while depression is a serious illness, it is also a treatable one. How Can I Tell if My Child Is Depressed? The symptoms of depression in children vary. It is often undiagnosed and untreated because they are passed off as normal emotional and psychological changes that occur during growth. Early medical studies focused on "masked" depression, where a child's depressed mood was evidenced by acting out or angry behavior. While this does occur, particularly in younger children, many children display sadness or low mood similar to adults who are depressed. The primary symptoms of depression revolve around sadness, a feeling of hopelessness, and mood changes. Signs and symptoms of depression in children include: Irritability or anger Continuous feelings of sadness and hopelessness Social withdrawal Increased sensitivity to rejection Changes in appetite -- either increased or decreased Changes in sleep -- sleeplessness or excessive sleep Vocal outbursts or crying Difficulty concentrating Fatigue and low energy Physical complaints (such as stomachaches, headaches) that don't respond to treatment Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests Feelings of worthlessness or guilt Impaired thinking or concentration Thoughts of death or suicide Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol, especially if they are over age 12. Although relatively rare in youths under 12, young children do attempt suicide -- and may do so impulsively when they are upset or angry. Girls are more likely to attempt suicide, but boys are more likely to actually kill themselves when they make an attempt. Children with a family history of violence, alcohol abuse, or physical or sexual abuse are at greater risk for suicide, as are those with depressive symptoms. By clicking Subscribe, I agree to the WebMD Terms & Conditions & Privacy Policy and understand that I may opt out of WebMD subscriptions at any time. close Depression in Children What Causes Depression in Children? As in adults, depression in children can be caused by any combination of factors that relate to physical health, life events, family history, environment, genetic vulnerability and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment. Can Depression in Children Be Prevented? Children with a family history of depression are at greater risk of experiencing depression themselves. Children who have parents that suffer from depression tend to develop their first episode of depression earlier than children whose parents do not. Children from chaotic or conflicted families, or children and teens who abuse substances like alcohol and drugs, are also at greater risk of depression. How Is Depression Diagnosed in Children? If the symptoms of depression in your child have lasted for at least two weeks, you should schedule a visit with his or her doctor to make sure there are no physical reasons for the symptoms and to make sure that your child receives proper treatment. A consultation with a mental health care professional who specializes in children is also recommended. A mental health evaluation should include interviews with you (the parent or primary caregiver) and your child, and any additional psychological testing that is necessary. Information from teachers, friends and classmates can be useful for showing that these symptoms are consistent during your child's various activities and are a marked change from previous behavior. There are no specific tests -- medical or psychological -- that can clearly show depression, but tools such as questionnaires (for both the child and parents) combined with personal information can be very useful in helping diagnose depression in children. Sometimes those therapy sessions and questionnaires can uncover other concerns that contribute to the depression such as ADHD, conduct disorder, and OCD. What Are the Treatment Options? Treatment options for children with depression are similar to those for adults, including psychotherapy (counseling) and medication. The role that family and the child's environment play in the treatment process is different from that of adults. Your child's doctor may suggest psychotherapy first, and consider antidepressant medicine as an additional option if there is no significant improvement. The best studies to date indicate that a combination of psychotherapy and medication is most effective at treating depression. Studies show that the antidepressant Prozac is effective in treating depression in children and teens. The drug is officially recognized by the FDA for treatment of children ages 8 to 18 with depression. Other medications may be chosen if there are other coexisting illnesses contributing to the depression. Treating Children With Bipolar Disorder Children with bipolar disorder are usually treated with psychotherapy and a combination of medicines, usually an antidepressant and a mood stabilizer. Antidepressants need to be used with caution as they can trigger bouts of manic or hyperactive behavior in children with bipolar disorder. The FDA warns that antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider. Additionally, if your child is placed on these medications, it is still very important to continue to follow closely with the physician and therapist. Long-Term Outlook Studies have found that first-time depression in children is occurring at younger ages than previously. As in adults, depression may occur again later in life. Depression often occurs at the same time as other physical illnesses. And because studies have shown that depression may precede more serious mental illness later in life, diagnosis, early treatment and close monitoring are crucial. As a parent, it is sometimes easier to deny that your child has depression. You may put off seeking the help of a mental health care professional because of the social stigmas associated with mental illness. It is very important for you -- as the parent -- to understand depression and realize the importance of treatment so that your child may continue to grow physically and emotionally in a healthy way. It is also important to seek education about the future effects depression may have on your child throughout adolescence and adulthood. Depression in Children: Warning Signs Parents should be particularly vigilant for signs that may indicate that their child is at risk for suicide. Warning signs of suicidal behavior in children include: Many depressive symptoms (changes in eating, sleeping, activities) Social isolation, including isolation from the family Talk of suicide, hopelessness, or helplessness Increased acting-out of undesirable behaviors (sexual/behavioral) Increased risk-taking behaviors Frequent accidents Substance abuse Focus on morbid and negative themes Talk about death and dying Increased crying or reduced emotional expression Giving away possessions

http://www.webmd.com/depression/guide/depression-children

Parents with Mental Health Issues

I’m a parent and I have mental health problems and/or a personality disorder. Can a social worker take my children away? “Don’t ever let anyone tell you that your mental health challenges make you a weak person or a bad parent. Living and surviving and managing with all that stress and noise in your head requires strength, more strength than many other people will ever even have to find from within themselves. You are strong. Very strong indeed” Debbie, aged 35, living with her four children and with lifelong schizoaffective disorder Historically, there has been stigma and prejudice associated with parenting whilst living with a mental health challenge or personality difficulty. In the past, individuals who had or had been diagnosed with problems with their mental health were at unjustified risk of having their children taken from them. However, from the very beginning of disability rights legislation in the 1990s, mental health conditions have been recognised as disabilities. Therefore, people with mental health conditions have gained the right to protection from discrimination and parents with mental health conditions have gained the entitlement to support from Adult Services in their parenting role. Therefore, the courts should never allow a Social Worker to remove a child from a parent simply because the parent has mental health difficulties. Instead, Children’s Services would need to provide the court with evidence to demonstrate one or more of the following scenarios; The mental health difficulties of the parent are of such severity that the parent cannot safely look after their child, even with the supervision of family members and/or the support of professional agencies, and that the parent is likely to have these difficulties for the foreseeable future. For example, Katie is suffering from psychosis, holds the resulting belief that she needs to add bleach to her son Liam’s baby formula and does not appear to understand why giving Liam bleach is harmful to him. Children’s Services would need to prove to the court that there was nothing Katie’s husband Rob or any professional could reasonably do to prevent Katie from feeding Liam with bleach before the court would allow a Social Worker to take Liam into care. The parent is not engaging with the mental health treatment or social support necessary to enable them to safely look after their children. For example, single mother Shenaz is very depressed and struggling to keep the house clean, get her daughters Amira and Aisha dressed and ready for school and doesn’t want to take anti-depressants or have counselling and refuses to accept help from her ex or her sisters. Children’s Services would need to prove to the court that they had done everything possible to encourage Shenaz to accept help before the court would allow a Social Worker to place Amira and Aisha with their father or aunt. The mental health difficulties of the pregnant woman involve a lifestyle so chaotic, risky or unpredictable that it is reasonable to believe that the newborn baby would be exposed to an unacceptable level of risk. For example, Shannon is six months pregnant and constantly moving between squats comprised of people who grow and use cannabis, a substance which Shannon uses to self-medicate against the voices she hears. Children’s Services would need to prove to the court that Shannon would be highly likely to try and raise her as-yet-unborn child surrounded by drugs and drug users, and thus at extreme risk of cot death, abuse and neglect. Mental health advocacy services are experienced at helping parents to articulate and to explain to professionals their difficulties, and are skilled at helping parents to locate and request the help they need. Therefore, if a parent with current or historic mental health difficulties is able to explain and understand their difficulties and to explain the support they need, they should not find themselves in danger of losing their children. However, this advice can be problematic for people in the following situations I have a diagnosis of personality disorder. Can a social worker take my children away? You may also be interested in this post about personality disorder. Personality disorder is a contentious and disputed diagnosis, and one which can be used in different ways or mean different things to different professionals. Most people with a diagnosis of personality disorder have had difficulties for a long time, and most find that mental health services have not been able to help them. Therefore, people with diagnoses of personality disorder can find it difficult to access or engage with the sort of help they need. Professionals – including doctors and social workers – can sometimes find people with a diagnosis of personality disorder confusing or intimidating, and difficult to help. Many people with a diagnosis of personality disorder manage well as parents. However, some parents with diagnoses of personality disorder do need some help. Most people with a diagnosis of personality disorder have a history of childhood abuse or neglect, and some may therefore need guidance in understanding how to keep their own children safe and cared for. Many people with a diagnosis of personality disorder struggle to manage relationships and emotions, and some may therefore need support in responding to the behaviour of their children. Some people with a diagnosis of personality disorder cope with stress in self-destructive ways such as by self-harm, substance abuse, eating problems or sexual risk-taking, and these people may need help in ensuring that their children are not affected by their behaviour. It is this latter category – those parents who are harming themselves, and whose children are witnessing them harming themselves or whose unborn children are affected by them harming themselves – who are most likely to attract the concern of professionals. However, before allowing a Social Worker to remove a child from a parent with a personality disorder, the court must ensure that everything possible has been done to help and support the parent. In the past, personality disorders were regarded as ‘untreatable’ and some people with diagnoses of personality disorder may still be told they are ‘untreatable’: however, this attitude is now recognised as discriminatory and does not remove from statutory services the legal obligation to try and help. There is help and support available for people with diagnoses of personality disorder: treatments such as mentalisation-based therapy (MBT), dialectic behaviour therapy (DBT), cognitive analytic therapy (CAT) and therapeutic communities have been demonstrated as reasonably effective. Therefore, unless a person with a diagnosis of personality disorder is refusing all help, their Social Worker must do everything possible to find them the support they need before considering whether to take their children away. The medication I’ve been given means that I sleep so soundly I don’t wake up if the baby needs me in the night – and I’m a single parent. Can the Social Worker take my children away? Excessive sleepiness is a well-known side-effect of much psychotrophic medication, particularly the older antipsychotics. When prescribing, psychiatrists should be willing to take lifestyle factors such as the possible need for waking quickly into account – for most people, there will be alternative forms of medication to try. When a physically-disabled single parent needs support at night, Adult Services should provide and fund a carer or personal assistant. Parents who have a similar need due to medication should therefore have a similar entitlement. Therefore, the court would insist that Adult Services provide the help parent needs as an alternative to removing the children. In practice, however, single parents with both physical and mental health disabilities often have to work quite hard to access and secure funding for such levels of help. Advocacy services such as those run by Mind and Rethink can be very effective. I know I need therapy to be a good enough parent, but my Social Worker says the waiting lists mean that I won’t even get an assessment for another six months and that even then I mightn’t get any help because I’m too unwell or live too far away. Can the Social Worker take my children away? It can be very difficult for parents with mental health difficulties and personality disorder diagnoses to find and receive the support they need. Waiting lists often exceed the government’s 18 week target and parents can feel very frightened and isolated in the meantime, which may increase the level of risk of harm or neglect they pose to their children. However, Children’s Services should never consider removing children simply because of the difficulties in accessing help for the parent. The courts should ensure that this will not happen. National mental health charities and local advocacy groups can also be useful in helping parents to find the help they need within a reasonable time-frame – such organisations can often be more aware of available resources than social workers or psychiatrists. I know I could manage with the children if I had daily visits from a support worker, weekly counselling and 24/7 access to the Crisis Team. My Social Worker agrees, but says that there’s not enough funding within the system available to give me that much help. Can they take my children simply because it’s cheaper than giving me the help I need? This is a scenario which should never arise. However, given the current budget cuts within the public sector, all local authorities are under pressure to save money, if only in the short term. Ultimately, the courts make decisions based upon the best interests of the child rather than on the financial convenience of the professionals involved. It would therefore be very difficult for Children’s Services to persuade a court to allow Social Workers to remove children simply to avoid the expense of supporting a parent. Parents who are struggling to obtain the help they need often benefit from a good solicitor and the support of advocacy services. See for example, the advocacy services run by Mind and Rethink which can be very effective. I have problems other than with my mental health. Sometimes I fall over and wet myself due to seizures I have, but the Social Worker think it happens because I’m drunk even though the doctor I saw at A&E last year could tell it was a medical problem. Can the Social Worker take my children for being drunk, even though I don’t even drink? People who have mental health problems often find that any unexplained physical symptoms will be attributed to their mental health or behaviour: this is known as ‘diagnostic overshadowing’, and is very common. Furthermore, Children’s Services and the NHS do not always share information as effectively as necessary, and records and letters can be inaccurate, worsening the problem. The Patient Advice and Liaison Service (PALS) are generally very good at ensuring that doctors provide Social Workers with all the information they need. If Children’s Services were to make a court application on the basis of inaccurate information, the solicitor of the parent should successfully be able to highlight and challenge any errors. When I am most distressed, I can find it hard to talk to people or to explain what is wrong. I’ve tried to write things down, but I’m not very good at reading and writing and I don’t always understand what professionals say or write. This means that the Social Worker sometimes thinks that I’m not cooperating – can they take my children away? Many people who have both mental health problems and difficulties with communication or literacy find that the anxiety, stress and confusion associated with their mental health can make it especially hard to explain to professionals what is wrong and to understand what they are being told to do. All professionals – and especially Social Workers – should be trained in working with and communicating with people with range of needs and difficulties. However, advocacy services can be helpful, especially when parents have additional learning difficulties. The Social Worker told me that she ‘doesn’t believe in people with schizophrenia being allowed to be parents’. Can she take my children away? As explained above, this opinion is discriminatory, and to act on it would be illegal. Social workers and other professionals may believe in many things and may hold a range of personal opinions. However, the law does not give professionals the authority to act on the basis of their individual views. Before a Social Worker is able to apply to the court for the removal of children, both the Social Worker and his/her manager will need to agree that the children should be removed, and the solicitor employed by the local authority will need to agree that there is a reasonable chance that the court will agree with them. No local authority solicitor would advise Children’s Services to initiate court action based simply upon such views expressed by one individual Social Worker. I’ve read some things online about Social Workers. I now realise that Children’s Services have hidden a camera in my daughter’s teddy, and I know that the way the Social Worker dyed her hair last week means that they’re going to take my daughter. Is this true? Certainly, there are some frightening things written online. Many of these appear to have been written by people who suffer the unusual or scary thoughts often associated with diagnoses of paranoia, some personality disorders or psychosis. If a parent is frightened by their thoughts or beliefs, and if the parent is finding it hard to get these thoughts or beliefs out of their head, he or she may be experiencing a deterioration of their mental health. Parents with a diagnosis of schizophrenia, bipolar disorder or personality disorder sometimes hear persecuting voices that others cannot hear, and these voices can include those of authority figures such as Social Workers and psychiatrists. Looking after children whilst experiencing such intense distress would be hard for any parent with or without mental health difficulties. The best thing a parent can do in this situation is therefore just to ask for help from a mental health professional or a trusted friend. I know that I need help in looking after my children and my partner does help – he’s a great dad and does everything for them. However, he beats me regularly and I’m scared to tell anyone because I know he’ll convince them that it’s just my mental health making me imagine the beatings… even if I do leave, I know he’d get full custody of the children and ban me from seeing them because I know I couldn’t look after them on my own. If I ask for help, can a Social Worker take my children away? This is probably one of the most difficult scenario for a parent with a mental health problem or personality disorder diagnosis. The Women’s Aid website provides some thoughtful and realistic advice here. Parents who find themselves in this very vulnerable position would do best to approach Children’s Services and mental health support via the support of an independent domestic violence advocate, who will help the Social Worker to understand what is happening and what will help. Some women’s refuges have intensive support available to mothers with specific mental health needs, and some refuges can allow women to stay for up to five years. However, the mother will need legal advice and representation to protect themselves from their abusive ex-partner, which is currently available free of charge to all domestic violence victims through legal aid. You might also find it helpful to visit our section on domestic violence and abuse. I’m on my own with the children all week and I’m hearing voices telling me to kill myself and I’m having thoughts of doing frightening things. I want to phone 999 and ask for help – but will a Social Worker come and take the children away? If the suicidal or severely distressed parent has no adult family members or friends around to help, it is possible that the children may be taken into temporary local authority care in order for the parent to receive the urgent help that s/he needs. Children’s Services should make a priority of initiating any longer-term support necessary to support the parent to care for children in the future. Therefore, the parent should never be afraid of asking for help in a crisis or emergency. PLEASE if you are feeling suicidal and you haven’t got anyone else you want to talk to, call the Samaritans. http://childprotectionresource.online/reporting-post-natal-depression/

The Emotional Lives of 8-10 Year Olds

Eight- to ten-year-old children are still in what researcher Erik Erikson calls the age of Industry vs Inferiority. Until partway through middle school, they are learning how to relate to peers, adjust to social rules, and evolve from free play to more elaborately structured interactions and expectations. For example, your child may describe elaborate recess games, where he can travel through time, see into the future, or tame magical creatures. He may talk about the various roles he plays, and how the group decides who plays what part as the adventure unfolds. It is through these social routines and rituals that children learn to enter the play, establish group membership, and then direct the interactions. Children this age frequently travel in groups, although girls will often pair off with close friends within larger circles. Boys, in contrast, have less intense interactions, but demonstrate increased loyalty to the group as a whole. Regardless of gender, the interactions are often defined by elaborate fantasy play, interactive games, rotating leaders, and cooperative goal-setting where participants work collaboratively toward a shared outcome. For example, a group of children may run an elaborate “economy” where they find items on the playground to sell for rock currency, such as grasshoppers, sticks, pieces of plastic, or even ice. There may be shopkeepers, merchants, scavengers, or even thieves who all play a part in ongoing storylines. On the flip side of the close bonds and friendships that form among this age group comes the increase in social cruelty and bullying. At around 8, children develop the ability to consider the intent behind an action or choice, along with the ability to take another’s perspective. As a consequence, children became capable of intentional meanness and social exclusion. However, in large part, most children this age will engage in such behaviors at one point or other. They are not bullies, but rather individuals who are ineffectively trying to assert (expected) power within relationships in inappropriate ways. To effectively influence future choices and social outcomes, we can help 8- to 10-year olds learn the tools they need to engage in more positive social interactions. Here's an online game to help kids think about bullying. One component of social and emotional growth in 8- to 10-year olds is their desire for increased independence from parents and siblings, and their increased desire to be seen as intelligent and knowledgeable. As they struggle to find the means to appropriately individuate, they can, at times, seem willful or defiant. Children begin negotiating for what they want or arguing their point of view, at home and with peers, applying their more highly developed thinking skills, advanced language abilities, and increased concentration skills. For example, your child may ask you why a boy in his class has no eyelashes. Your logical reply might be that the boy has blonde hair and his eyelashes are simply hard to see. A concrete operational child will reason, “But my friend Emily has blonde hair and I can see her eyelashes, and Joey has blonde hair and I can see his eyelashes too. So why can’t I see Jeff’s?” Supporting children this age means actively listening to their goals and remaining on their side as they achieve them, while simultaneously maintaining necessary limits and boundaries. Thus, instead of controlling your child, you are guiding him to learn to control himself. Some non-confrontational ways to do this: give him a small budget to choose clothes that match his style, allow him choice in deciding the family menu, and give him veto power when selecting activities. To help your child learn to set SMART (Specific, Measurable, Attainable, Relevant, Time-oriented) goals, try this interactive. Recognizing your child’s need to pull away will also go a long way to keeping you on the same team. Allow peers to take on new importance. They provide a “mini society” your child can visit and experiment with while maintaining the safety net of a loving and supportive family to fall back on. In addition to a new emphasis on friends, “crushes” often make their appearance during these years. The feelings are not sexual; thus, same sex crushes are common and say nothing about a child’s sexuality in adolescence. Invite your child to speak openly about crushes or other social musings, but respect his desire for a private life or his wish to try and work out his problems independently. To start the conversation, ask your child the kinds of games the boys and girls play together at recess. Getting your child talking about the kinds of play he witnesses or partakes in is the first step. Welcoming all sorts of emotional reactions to that play is the next step. Your child is learning social roles and limits and the best person to help him do that, is you! As is true in all aspects of development, how your child feels about his skills and competence in other developmental areas (e.g., how he is doing in school) effects how he feels about himself socially, and impacts what challenges he is willing to take on. In fact, parents may hear increased self-criticism during these years, a natural by-product of their child’s developmental advancements. Children this age enjoy sharing their point-of-view and can more easily manage emotions to fit the situation. They are better able to select and adapt coping strategies to the variety of situations they now find themselves in. For example, your child may hold in his feeling of injustice until he gets home, or until he is alone with his friends. In this way, he is able and ready to learn new ways of successfully interacting with both peers and adults, and benefit from adults’ continued efforts to connect with and guide them. To help connect with your child around social struggles or bullying, take a look at the video and activities on this site. Do them with your child and see what conversations ensue. Developing metacognitive skills (ability to reflect on their thoughts) allow children to identify specific characteristics about their emotional selves and the abilities they possess (e.g., “I feel sad because”, or “I know I’m a strong swimmer because”). Being able to better preview actions and outcomes allows them to prepare for interactions and expectations. Children understand the importance of social customs (e.g., saying thank you), but may struggle to manage their emotions when they are overwhelmed by frustration or a series of personal setbacks. Your child’s ability to listen to reason has increased and he depends less on routines to provide a stable emotional state. Children this age experience subtleties of emotion (e.g., disappointment, resignation, resolve, focus, etc.), and they can apply these new understandings to social relations with peers. Before the age of 10, children understand the role of conflicting friendships, and they can mend fences after an argument. Children now have a more stable basis for choosing friends: shared interests, ability to give and take, responsiveness to one another’s needs, and desire for positive qualities such as kindness or trustworthiness. http://www.scholastic.com/parents/resources/article/stages-milestones/emotional-lives-8-10-year-olds

Childhood adversities and early-onset mental disorders associated with higher rates of chronic physical problems in adulthood

Date: August 2, 2011 Source: JAMA and Archives Journals Summary: Children who experience psychosocial adversities and early-onset mental disorders appear to be at increased risk of developing chronic physical conditions later in life, according to a new study. Share: Children who experience psychosocial adversities and early-onset mental disorders appear to be at increased risk of developing chronic physical conditions later in life, according to a report in the August issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Child maltreatment has been associated with increased risk of adverse physical health outcomes, according to background information in the article. However, the authors note, limitations to previous studies include failure to control for the potentially biasing effects that current mental disorder has on recall of childhood adversities, predominant focus on a single adversity and sample homogeneity in terms of race and ethnicity, age and sex. "In prior research that has considered the influence of the early psychosocial environment on later physical health, mental disorders have generally been out of the frame of consideration, which may be an important oversight," write the authors. They add that "the span of time during which mental-physical sequential associations may be developing has important implications for the understanding of mechanisms and the planning of interventions." Kate M. Scott, Ph.D., from the University of Otago, Dunedin, New Zealand, and colleagues examined data from 10 countries that participated in the World Health Organization World Mental Health Surveys initiative. These cross-sectional community surveys were conducted in person by trained lay interviewers. Participants who met criteria for any mental disorder in part one of the survey, and a probability sample of other participants, also completed part two, which included assessment of chronic physical conditions and childhood adversities. Mental disorders were assessed by the definitions and criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; those included in this research were anxiety disorders and depression. Childhood adversities included abuse, neglect, loss of a parent through death or other means, divorce, parental substance use, parental criminal behavior, family violence and family economic adversity. A checklist adapted from the U.S. Health Interview Schedule was used to assess chronic physical conditions. Each of the early-onset mental disorders included was associated with adult onset of three chronic pain conditions (osteoarthritis, chronic spinal pain [back or neck] and frequent or severe headache). Physical abuse as a child was associated with each of the chronic disease outcomes included by researchers (heart disease, asthma, diabetes mellitus, osteoarthritis, chronic spinal pain and headache). After adjusting for childhood adversities, early-onset mental disorders were still associated with adult-onset chronic physical conditions. The results also suggest a dose-response relationship, with a greater number of childhood adversities associated with a greater likelihood of adult-onset chronic physical conditions. "These results are consistent with the hypothesis that childhood adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life," the authors conclude. Story Source: Materials provided by JAMA and Archives Journals. Note: Content may be edited for style and length. Journal Reference: K. M. Scott, M. Von Korff, M. C. Angermeyer, C. Benjet, R. Bruffaerts, G. de Girolamo, J. M. Haro, J.-P. Lepine, J. Ormel, J. Posada-Villa, H. Tachimori, R. C. Kessler. Association of Childhood Adversities and Early-Onset Mental Disorders With Adult-Onset Chronic Physical Conditions. Archives of General Psychiatry, 2011; 68 (8): 838 DOI: 10.1001/archgenpsychiatry.2011.77 Cite This Page: MLA APA Chicago JAMA and Archives Journals. "Childhood adversities and early-onset mental disorders associated with higher rates of chronic physical problems in adulthood." ScienceDaily. ScienceDaily, 2 August 2011. https://www.sciencedaily.com/releases/2011/08/110801172826.htm

What is early-onset Bipolar Disorder?

Bipolar Disorder is a serious mental illness characterized by recurrent episodes of depression, mania, and/or mixed symptom states. These episodes cause unusual and extreme shifts in mood, energy, and behavior that interfere significantly with normal, healthy functioning. Manic symptoms include: Severe changes in mood - either extremely irritable or overly silly and elated Overly-inflated self-esteem; grandiosity Increased energy Decreased need for sleep - able to go with very little or no sleep for days without tiring Increased talking - talks too much, too fast; changes topics too quickly; cannot be interrupted Distractibility - attention moves constantly from one thing to the next Hypersexuality - increased sexual thoughts, feelings, or behaviors; use of explicit sexual language Increased goal-directed activity of physical agitation Disregard of risk - excessive involvement in risky behaviors or activities. Depressive symptoms include: Persistent sad or irritable mood Loss of interest in activities once enjoyed Significant change in appetite or body weight Difficulty sleeping or oversleeping Physical agitation or slowing Loss of energy Feelings of worthlessness or inappropriate guilt Difficulty concentrating Recurrent thoughts of death or suicide Symptoms of mania and depression in children and adolescents may manifest themselves through a variety of different behaviors. When manic, children and adolescents, in contrast to adults, are more likely to be irritable or prone to destructive outbursts than to be elated or euphoric. When depressed, there may be many physical complaints such as headaches, muscle aches, stomachaches or tiredness, frequent absences from school or poor performance in school, talk of or efforts to run away from home, irritability, complaining, unexplained crying, social isolation, poor communication, and extreme sensitivity to rejection or failure. Other manifestations of manic and depressive states may include alcohol or substance abuse and difficulty with relationships. Existing evidence indicates that Bipolar Disorder beginning in childhood or early adolescence may be a different, possibly more severe, form of the illness than older adolescent- and adult-onset Bipolar Disorder. When the illness begins before or soon after puberty, it is often characterized by a continuous, rapid-cycling, irritable, and mixed symptom state that may co-occur with disruptive behavior disorders, particularly attention deficit hyperactivity disorder (ADHD) or conduct disorder (CD), or may have features of these disorders as initial symptoms. In contrast, later adolescent- or adult-onset Bipolar Disorder tends to begin suddenly, often with a classic manic episode, and to have a more episodic pattern with relatively stable periods between episodes. There is also less co-occurring with ADHD or CD among those with later onset illness. A child or adolescent who appears to be depressed or exhibits ADHD-like symptoms that are very severe, with excessive temper outbursts and mood changes, should be evaluated by a psychiatrist or psychologist with experience in Bipolar Disorder, particularly if there is a family history of the illness. This evaluation is especially important since psychostimulant medications, often prescribed for ADHD, may worsen manic symptoms. There is also limited evidence suggesting that some of the symptoms of ADHD may be a forerunner of full-blown mania. Findings from an NIMH-supported study suggest that the illness may be at least as common among youths as among adults. In this study, one percent of adolescents ages 14-18 were found to have met criteria for Bipolar Disorder or cyclothymia, a similar but milder illness, in their lifetime. In addition, close to six percent of adolescents in the study had experienced a distinct period of abnormally and persistently elevated, expansive, or irritable mood even though they never met full criteria for Bipolar Disorder or cyclothymia. Compared to adolescents with a history of major depressive disorder and to a never-mentally-ill group, both the teens with Bipolar Disorder and those with subclinical symptoms had greater functional impairment and higher rates of co-occurring illnesses (especially anxiety and disruptive behavior disorders), suicide attempts, and mental health services utilization. The study highlights the need for improved recognition, treatment, and prevention of even the milder and subclinical cases of Bipolar Disorder in adolescence. Bipolar Disorder in Children and Teens Does your child go through intense mood changes? Does your child have extreme behavior changes? Does your child get much more excited and active than other kids his or her age? Do other people say your child is too excited or too moody? Do you notice he or she has highs and lows much more often than other children? Do these mood changes affect how your child acts at school or at home? Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. This brochure will give you more information. What is bipolar disorder? Bipolar disorder is a serious brain illness. It is also called manic-depressive illness or manic depression. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or “up,” and are much more energetic and active than usual, or than other kids their age. This is called a manic episode. Sometimes children with bipolar disorder feel very sad and “down,” and are much less active than usual. This is called depression or a depressive episode. Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The mood swings are more extreme and are accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms are so strong, they can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide. Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives. Who develops bipolar disorder? Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime. Why does someone develop bipolar disorder? Doctors do not know what causes bipolar disorder, but several things may contribute to the illness. Family genes may be one factor because bipolar disorder sometimes runs in families. However, it is important to know that just because someone in your family has bipolar disorder, it does not mean other members of the family will have it as well. Another factor that may lead to bipolar disorder is the brain structure or the brain function of the person with the disorder. Scientists are finding out more about the disorder by studying it. This research may help doctors do a better job of treating people. Also, this research may help doctors to predict whether a person will get bipolar disorder. One day, doctors may be able to prevent the illness in some people. What are the symptoms of bipolar disorder? Bipolar “mood episodes” include unusual mood changes along with unusual sleep habits, activity levels, thoughts, or behavior. In a child, these mood and activity changes must be very different from their usual behavior and from the behavior of other children. A person with bipolar disorder may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day. Children and teens having a manic episode may: Feel very happy or act silly in a way that’s unusual for them and for other people their age Have a very short temper Talk really fast about a lot of different things Have trouble sleeping but not feel tired Have trouble staying focused Talk and think about sex more often Do risky things Children and teens having a depressive episode may: Feel very sad Complain about pain a lot, such as stomachaches and headaches Sleep too little or too much Feel guilty and worthless Eat too little or too much Have little energy and no interest in fun activities Think about death or suicide Can children and teens with bipolar disorder have other problems? Young people with bipolar disorder can have several problems at the same time. These include: Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs. Attention deficit/hyperactivity disorder (ADHD). Children who have both bipolar disorder and ADHD may have trouble staying focused. Anxiety disorders, like separation anxiety. Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, such as driving too fast or spending too much money. Some young people with bipolar disorder think about suicide. Watch for any signs of suicidal thinking. Take these signs seriously and call your child’s doctor. How is bipolar disorder diagnosed? An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child’s mood and sleeping patterns. The doctor will also ask about your child’s energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if something other than bipolar disorder is causing your child’s symptoms. How is bipolar disorder treated? Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in much the same way they treat adults. Treatment can help control symptoms. Steady, dependable treatment works better than treatment that starts and stops. Treatment options include: Medication. There are several types of medication that can help. Children respond to medications in different ways, so the right type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them. Children should take the fewest number of medications and the smallest doses possible to help their symptoms. A good way to remember this is “start low, go slow.” Medications can cause side effects. Always tell your child’s doctor about any problems with side effects. Do not stop giving your child medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse. Therapy. Different kinds of psychotherapy, or “talk” therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members. What can children and teens expect from treatment? With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together. Sometimes a child’s bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms. You can help treatment be more effective. Try keeping a chart of your child’s moods, behaviors, and sleep patterns. This is called a “daily life chart” or “mood chart.” It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working. How can I help my child or teen? Help begins with the right diagnosis and treatment. If you think your child may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice. If your child has bipolar disorder, here are some basic things you can do: Be patient. Encourage your child to talk, and listen to your child carefully. Be understanding about mood episodes. Help your child have fun. Help your child understand that treatment can make life better. How does bipolar disorder affect parents and family? Taking care of a child or teenager with bipolar disorder can be stressful for you, too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time. If you are taking care of a child with bipolar disorder, take care of yourself too. Find someone you can talk to about your feelings. Talk with the doctor about support groups for caregivers. If you keep your stress level down, you will do a better job. It might help your child get better too. Where do I go for help? If you’re not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency. Finally, the Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to help you find mental health services in your area. You can find it here: https://findtreatment.samhsa.gov . I know someone who is in crisis. What do I do? If you know someone who might be thinking about hurting himself or herself or someone else, get help quickly. Do not leave the person alone. Call your doctor. Call 911 or go to the emergency room. Call National Suicide Prevention Lifeline, toll-free: 1-800-273-TALK (8255). The TTY number is 1-800-799-4TTY (4889). For more information on conditions that affect mental health, resources, and research, go to MentalHealth.gov at http://www.mentalhealth.gov , or the NIMH website at http://www.nimh.nih.gov. In addition, the National Library of Medicine’s MedlinePlus service has information on a wide variety of health topics, including conditions that affect mental health. National Institute of Mental Health Office of Science Policy, Planning, and Communications Science Writing, Press, and Dissemination Branch 6001 Executive Boulevard Room 6200, MSC 9663 Bethesda, MD 20892-9663 Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free TTY: 301-443-8431 or 1-866-415-8051 toll-free Fax: 301-443-4279 Email: nimhinfo@nih.gov Website: http://www.nimh.nih.gov U.S. Department of Health and Human Services National Institutes of Health National Institute of Mental Health NIH Publication No. QF 15-6380 Revised 2015 http://www.ryanlichtsangbipolarfoundation.org/site/c.ltJZJ8MMIsE/b.2107349/k.4471/What_is_earlyonset_Bipolar_Disorder.htm

Childhood-Onset Schizophrenia

Background Childhood-onset schizophrenia is a severe form of psychotic disorder that occurs at age 12 years or younger and is often chronic and persistently debilitating. The definition of childhood schizophrenia has evolved over time and is now believed to be a virulent childhood version of the same disorder exhibited in adolescents and adults. The American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) cautions that although the essential features of schizophrenia are the same in childhood, it is harder to diagnose. Children may experience less elaborate delusions and hallucinations than adults. Visual hallucinations are more common in child schizophrenics and should be distinguished from normal fantasy play. Symptoms such as disorganized speech and behavior, which are typically present in schizophrenia, also occur in many disorders of childhood onset (e.g., autism spectrum disorder and attention-deficit hyperactivity disorder). It is important to consider these more common disorders of childhood before attributing symptoms to schizophrenia. [1] Diagnostic criteria (DSM-5) SM-5 diagnostic criteria for schizophrenia requires at least two of the following five symptoms to be present for a month. [1] At least one of these must be (1), (2), or (3): Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behavior Negative symptoms Other criteria include a markedly lower level of functioning in one or more major areas, such as work, interpersonal relations or self-care; persistence of continuous signs of disturbance for at least 6 months; the ruling out of schizoaffective disorder; and the exclusion of substance abuse or another medical condition that may be causing the disturbance. In patients with a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms or schizophrenia are also present for at least 1 month (or less if successfully treated). In addition to the five symptom domain areas identified in the diagnostic criteria, the assessment of cognition, depression, and mania symptom domains is vital for making critically important distinctions between schizophrenia and other psychotic disorders. The American Psychiatric Association removed schizophrenia subtypes from the DSM-5 because they didn’t appear to help with providing better targeted treatment, or predicting treatment response. However, those individuals meeting the criteria for catatonia would receive an additional diagnosis of catatonia associated with schizophrenia to indicate the presence of the comorbidity. The following duration specifiers are used only after 1-year duration of the disorder and they are not in contradiction to the diagnostic course criteria: First episode, currently in acute episode First episode, currently in partial remission First episode, currently in full remission Multiple episodes, currently in acute episode Multiple episodes, currently in partial remission Multiple episodes, currently in full remission Continuous Etiology No definite single etiology of schizophrenia has been identified. Most theories accept both genetic and environmental contributions for the causation of childhood-onset schizophrenia. A review of the data from the Environmental Risk Longitudinal Twin Study of British Children found that childhood psychotic symptoms are familial and heritable. These symptoms are associated with social risk factors; cognitive impairments at age 5 years; home-rearing risk factors; behavioral, emotional, and educational problems at age 5 years; and comorbid conditions such as self-harm. Therefore, childhood psychotic disorders may be a marker of an impaired developmental process. [3] In addition, compared with the usual onset of schizophrenia in late adolescence or early adulthood, the emergence of earlier-onset schizophrenia during childhood may be due to increased genetic loading for schizophrenia or early central nervous system (CNS) damage due to an environmental factor. Genetic risk Several factors suggest a genetic risk. First-degree relatives of children with schizophrenia have a higher prevalence rate of schizophrenia and schizophrenia spectrum disorders. [4] In the Pittsburgh High-Risk Study, findings among young relatives of schizophrenia patients included the following [5] : High proportions of axis I psychopathology, especially attention deficit hyperactivity disorder (ADHD) and conduct disorder Increased expressed emotion among relatives A trend for more psychopathology in offspring of relatives with high expressed emotion Impaired attention, spatial working memory, and executive functions Increased soft neurologic signs Volume reductions in the amygdala, hippocampus, and superior temporal gyrus Decreased slow-wave sleep First-degree relatives of individuals with schizophrenia have impairment in ocular smooth pursuit movements similar to that found on examination of patients with schizophrenia. One study found that healthy siblings of patients with childhood-onset schizophrenia had decreased cerebral gray matter in the same pattern as was seen in the patients. [6] Examination of National Institute of Mental Health patients with onset of schizophrenia before age 13 years revealed a 10% rate of cytogenetic abnormalities. [7] In addition, associations with several schizophrenia-susceptibility genes in adult patient cohorts were replicated in the childhood-onset schizophrenia patients, including DAOA, NRG1, DTNBP1, and GAD1. [8] There was also an excess of novel copy number variants that overlapped or disrupted known genes in patients when compared with the nontransmitted parental “control” chromosomes. [9] Neurodevelopmental and neurobiologic abnormalities Several studies have described complications during pregnancy and delivery in adults who subsequently develop schizophrenia. The combination of genetic risk and evidence of acquired damage has suggested a neurodevelopmental theory with early CNS abnormalities that contribute to an increased vulnerability to schizophrenia later in life. An increase in minor dysmorphic features has suggested prenatal-onset problems. An increase in hypoxia-associated complications was demonstrated to increase the odds of developing earlier-onset schizophrenia. The neurobiologic substrate of persons with childhood-onset schizophrenia has been examined by neuroimaging. As in adults with schizophrenia, the most consistent finding has been enlargement of the lateral ventricles. Although static in adults, the abnormalities in brain morphology evolve during adolescence. The possibility of a neurodegenerative process has been raised but also questioned. [10] Rapoport et al demonstrated that adolescents with schizophrenia have significantly greater decreases in frontal and temporal gray matter volumes than those observed in healthy age-matched controls (see the images below). [11, 12] The investigators additionally found the children with schizophrenia to have more cortical gray matter loss than children with transient psychosis. Subsequent studies from this group have also shown reduced cerebral volume and gray matter in healthy siblings of patients with childhood-onset schizophrenia. However, later studies of nonpsychotic siblings of childhood-onset schizophrenia patients have shown a pattern of prefrontal and temporal gray matter deficits during early ages that seem to normalize by the time the subjects reach late adolescence. [13] These results were replicated by Mattai et al, who also showed nonpsychotic siblings of childhood-onset schizophrenia patients have early gray matter deficits that improve over time, suggesting that late adolescence may be a critical time for greatest localization of deficits in probands or normalization in nonpsychotic siblings. [14] Childhood schizophrenia. Early and late gray matte Childhood schizophrenia. Early and late gray matter deficits in schizophrenia. Areas of gray matter loss, shown in red and yellow, spread from back-to-front (right to left) over 5 years in composite MRI scan data from 12 teens with childhood-onset schizophrenia, beginning at age 14 (left). Red and yellow denotes areas of greater loss. Source: Paul Thompson, MD, UCLA, Laboratory of Neuroimaging. NIMH media file. View Media Gallery Childhood schizophrenia. Rate of gray matter loss. Childhood schizophrenia. Rate of gray matter loss. Composite MRI scan data showing areas of gray matter loss over 5 years, comparing 12 normal teens (left) and 12 teens with childhood-onset schizophrenia. Red and yellow denotes areas of greater loss. Front of brain is at left. Source: Paul Thompson, MD, UCLA, Laboratory of Neuroimaging. NIMH media file. View Media Gallery The Edinburgh High-Risk Study suggested that, in high-risk subjects (defined as subjects who had at least 2 close relatives with schizophrenia), the change from vulnerability to psychosis may be preceded by reduction in size and deteriorating function of the temporal lobe. [15] In a systematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls, meta-analysis suggested that the whole brain and hippocampal volume are reduced and that ventricular volume is increased in affected patients relative to healthy controls. [16] Furthermore, brain magnetic resonance scans obtained in childhood-onset schizophrenia subjects, their nonpsychotic full siblings, and matched health comparison subjects between the ages of 10-29 years that measured the total, left, and right hippocampal volumes showed that childhood-onset schizophrenia patients had a fixed reduction in hippocampal volumes when compared with nonpsychotic siblings and health comparison subjects. In addition, no significant volumetric or trajectory differences were noted between nonpsychotic siblings and healthy comparison subjects. Therefore, decreased hippocampal volume may represent an intermediate disease phenotype. [17] Greenstein et al reported that cortical thickness loss in childhood-onset schizophrenia appears to localize with age to prefrontal and temporal regions that are seen in patients with adult-onset schizophrenia, regardless of medication. [18] Another study showed that childhood-onset schizophrenia patients who met criteria for remission had thicker gray matter in prefrontal, temporal, and parietal cortices compared with nonremitted patients, suggesting a possible relation of brain plasticity with prognosis. [19] Cannabis use Evidence from 6 longitudinal studies in 5 countries showed that regular cannabis use predicts an increased risk of a schizophrenia diagnosis or of reporting symptoms of psychosis. [20] One study found that 74% of cannabis use disorders subjects had the onset of cannabis use disorder before the onset of positive psychotic symptoms. These subjects were predominately male, younger at study entry, had an earlier age at onset of positive symptoms, less educational attainment, a lower self-socioeconomic status, better premorbid childhood social adjustment, a trend for poorer premorbid childhood academic adjustment, less motor abnormalities, but more severe hallucinations and delusions. However, in the multivariate analysis only male sex, worse socioeconomic status, better premorbid childhood social adjustment, and more severe positive symptoms at study entry were associated with a lifetime history of cannabis use disorder. The authors concluded that although cannabis use precedes the onset of illness in most patients, no significant association existed between onset of illness and cannabis use disorders that was not accounted for by demographic and clinical variables. [21] Nevertheless, another study used the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) to assess for a possible association between cannabis use, traumatic events, and psychotic symptoms in adolescence. Cannabis use and childhood trauma were significantly associated with a risk of experiencing psychotic symptoms. When cannabis use and childhood trauma occurred within the same patient, the risk for psychotic symptoms increased beyond the risk posed by either factor alone. However, only 14 participants in the study reported experiencing psychotic symptoms. Therefore, these findings must be replicated. [22] A 2012 study obtained T1-weighted MRIs from adolescents with earlier-onset schizophrenia (EOS), cannabis use disorders (CUD), EOS plus CUD, and healthy controls. In the EOS group and the CUD group, the left superior parietal region had smaller gray matter volumes compared with healthy controls. The combined EOS/CUD group showed similar findings, but no additive effect was found. Nevertheless, the combined EOS/CUD group had smaller gray matter volumes in the left thalamus compared with the CUD and healthy control groups. [23] Early adolescent cannabis use coupled with a specific genetic vulnerability may be a risk factor for the development of schizophrenia. Early childhood trauma As previously stated, early childhood trauma has been correlated with childhood psychotic symptoms. Specifically, Arsenault et al obtained data from the Environmental Risk longitudinal Twin Study, which interviewed mothers when their children were aged 5, 7, 10, and 12 years on whether the children had experienced maltreatment by an adult, bullying by peers, or involvement in an accident. When the children were aged 12 years, they were asked about bullying experiences and psychotic symptoms. Children who experienced maltreatment by an adult or bullying by peers were more likely to report psychotic symptoms at age 12 years than were children who did not experience maltreatment. The finding of higher risk of psychotic disorders was observed whether these events occurred early in life of later in childhood. In addition, this finding remained significant when sex, socioeconomic deprivation, internalizing or externalizing problems, children’s genetic liability to developing psychosis, and IQ were controlled. [24] Furthermore a prospective cohort study of 12-year-old children assessed the risk of psychotic symptoms using the Psychosis-like Symptoms Interview. Children who had been victims of bullying at ages 8 and/or 10 years, independent of prior psychopathology, family adversity, or child’s IQ, had a 2-fold increase in risk of psychotic symptoms. The risk increased when victimization was chronic or severe. [25] Infections One study also found a link between viral CNS infections and later psychosis. Specifically, a national cohort of children born between 1973-1985 was followed by using Swedish national registers to determine the association between CNS infections at age 0-12 years and admissions for nonaffective psychotic illnesses from the 14th birthday (N=2269). There was a slightly increased risk of nonaffective psychotic illness associated with viral CNS infections, as well as schizophrenia. There was no increased risk in relation to bacterial infections. Exposure to mumps virus or cytomegalovirus were associated with later psychosis. [26] However further research into this correlation is needed. Neurotransmitters and schizophrenia Most psychologic, pharmacologic, and neuroimaging studies of childhood-onset schizophrenia have suggested dysfunction in the prefrontal cortex and limbic system. The neurotransmitter implicated in the pathophysiology of schizophrenia is dopamine. Drugs that increase dopaminergic activity may induce a schizophreniform psychosis, and drugs that block postsynaptic D2 receptors help alleviate symptoms of schizophrenia. Other neurotransmitters may also be involved in the pathophysiology of schizophrenia. Glutamate has been implicated based, in part, on the production of psychotic symptoms by phencyclidine and the presence of N -methyl-D-aspartate (NMDA) receptor dysfunction. [27] Serotonin may be important. The new atypical antipsychotic drugs have prominent serotonergic effects. Preliminary studies suggest gamma-aminobutyric acid (GABA) may be important. Epidemiology Childhood-onset schizophrenia is rare in the United States; in preadolescents, the estimated prevalence is less than 1 case per 10,000 population. The number of new cases significantly increases during late adolescence, reaching an approximate prevalence of 1% for later-onset schizophrenia. Globally, schizophrenia with an onset later in life appears to have an equal prevalence, with a possible increase in prevalence in urban populations. No studies of prevalence of childhood-onset schizophrenia in underdeveloped countries are available. Most studies demonstrate an average male-to-female incidence of schizophrenia of 1.5-2:1. No studies of childhood-onset schizophrenia that allow comparisons based on race or ethnicity are available, nor are studies about the prevalence in underdeveloped nations. The 2006 Aetiology and Ethnicity in Schizophrenia and Other Psychoses Study (AESOP), a large, population-based case-control study conducted over two years in three study centers in England in adults, reported all psychoses were more common in the black and minority ethnic group compared with the white British group. [28] In a child younger than 13 years, the onset of schizophrenia is rare and is generally insidious, carrying a worse prognosis. Onset of the disorder in the adolescent years is more common and may have an acute or insidious onset. In general, the earlier the onset of schizophrenia, the poorer the outcome. Prognosis The prognosis for childhood-onset schizophrenia and adolescent-onset schizophrenia is worse than that observed in adult-onset schizophrenia. As adults, these children experience the following: Fewer close social relationships Less academic achievement More unemployment Less capacity for independent living Patients with an onset before adolescence and those with an insidious onset appear to have a worse response to medication and a worse prognosis. An increased risk of death from suicide is present in patients with schizophrenia. In large follow-up studies of childhood-onset schizophrenia, the mortality rate from suicide is 5-11%. In follow-up studies, more than 50% of children with schizophrenia have persistent severe impairment in social skills and limitations in academic and occupational achievement. Approximately 10% of adults with schizophrenia commit suicide. Violence is also a potential problem, particularly for the adolescent with paranoid ideation. Other complications arise from poor self-care, impulsivity leading to injury or sexually acquired diseases, and substance abuse. Patient Education Psychoeducation is essential for families of children with schizophrenia. They need to be educated about the causes, symptoms, natural history, therapy, adverse effects of medication, and complications of childhood-onset schizophrenia. Families must also know the warning signs of impending relapse. High levels of expressed emotion have been associated with an increased risk of relapse in adults with schizophrenia and can possibly contribute to problems in children with schizophrenia. Once children with schizophrenia are in remission, teach them to self-monitor for signs of possible relapse. Inform these children about possible adverse effects of medication. For patient education information, see Mental Health and Behavior Center, as well as Schizophrenia. http://emedicine.medscape.com/article/914840-overview

Early Signs of Schizophrenia

The following list, compiled by one mental health consumer, contains some of the typical early warning signs of schizophrenia. Keep in mind that schizophrenia onset is typically between the ages of 15 and 25 (although it can affect children younger than fourteen, with a subtype known as childhood-onset schizophrenia). The disorder can come on over a period of years (called insidious onset) or be very rapid. It affects 1% of the general population. The list is subdivided into Physical Symptoms, Feelings and Mood, Behavior, Cognitive Problems, Delusions, and Hallucinations. Please remember that only a qualified psychologist, psychiatrist (or in some areas a social worker) can properly diagnose schizophrenia, or any other brain disorder. A psychologist or psychiatrist will use the clinical history of the person, as well as the symptoms and criteria in the DSM-IV (in the United States) to make a diagnosis. Examples of Physical Symptoms---- --A blank, vacant facial expression. An inability to smile or express emotion through the face is so characteristic of the disease that it was given the name of affective flattening or a blunt affect. --Overly acute senses- lights are too bright, sounds are too loud. --Staring, while in deep thought, with infrequent blinking. --Clumsy, inexact motor skills --Sleep disturbances- insomnia or excessive sleeping --Involuntary movements of the tongue or mouth (facial dyskinesias). Grimacing at the corners of the mouth with the facial muscles, or odd movements with the tongue. --Parkinsonian type symptoms- rigidity, tremor, jerking arm movements, or involuntary movements of the limbs --An awkward gait (how you walk) --Eye movements- difficulty focusing on slow moving objects --Unusual gestures or postures --Movement is speeded up- i.e. constant pacing --Movement is slowed down- staying in bed (in extreme cases, catatonia) Examples of Feelings/Emotions---- --The inability to experience joy or pleasure from activities (called anhedonia) --Sometimes feeling nothing at all --Appearing desireless- seeking nothing, wanting nothing --Feeling indifferent to important events --Feeling detached from your own body (depersonalization) --Hypersensitivity to criticism, insults, or hurt feelings Examples of Mood---- --Sudden irritability, anger, hostility, suspiciousness, resentment --Depression- feeling discouraged and hopeless about the future --Low motivation, energy, and little or no enthusiasm --Suicidal thoughts or suicidal ideation --Rapidly changing mood- from happy to sad to angry for no apparent reason (called labile mood) --Severe Anxiety Changes in Behavior associated with schizophrenia ---- --Dropping out of activities and life in general --Inability to form or keep relationships --Social isolation- few close friends if any. Little interaction outside of immediate family. --Increased withdrawal, spending most of the days alone. --Becoming lost in thoughts and not wanting to be disturbed with human contact --Neglect in self-care- i.e. hygiene, clothing, or appearance --Replaying or rehearsing conversations out loud- i.e. talking to yourself (very common sign) --Finding it difficult to deal with stressful situations --Inability to cope with minor problems --Lack of goal-directed behavior. Not being able to engage in purposeful activity --Functional impairment in interpersonal relationships, work, education, or self-care --Deterioration of academic or job-related performance --Inappropriate responses- laughing or smiling when talking of a sad event, making irrational statements. --Catatonia- staying in the same rigid position for hours, as if in a daze. --Intense and excessive preoccupation with religion or spirituality --Drug or alcohol abuse --Smoke or have the desire to want to smoke (70-90% do smoke) - note: this is a very normal behavior for people who do not have schizophrenia also! --Frequent moves, trips, or walks that lead nowhere Examples of Cognitive Problems Associated with Schizophrenia ---- --Ruminating thoughts- these are the same thoughts that go around and round your head but get you nowhere. Often about past disappointments, missed opportunities, failed relationships. --Making up new words (neologisms) --Becoming incoherent or stringing unrelated words together (word salad) --Frequent loose association of thoughts or speech- when one thought does not logically relate to the next. For example, "I need to go to the store to buy some band-aids. I read an article about how expensive AIDS drugs are. People take too many street drugs. The streets should be clean from the rain today, etc" The need to go to the store to buy band-aids is forgotten. --Directionless- lack goals, or the ability to set and achieve goals --Lack of insight (called anosognosia). Those who are developing schizophrenia are unaware that they are becoming sick. The part of their brain that should recognize that something is wrong is damaged by the disease. --Racing thoughts --In conversation you tend to say very little (called poverty of speech or alogia) --Suddenly halting speech in the middle of a sentence (thought blocking) --Trouble with social cues- i.e. not being able to interpret body language, eye contact, voice tone, and gestures appropriately. --Often not responding appropriately and thus coming off as cold, distant, or detached. --Difficulty expressing thoughts verbally. Or not having much to say about anything. --Speaking in an abstract or tangential way. Odd use of words or language structure --Difficulty focusing attention and engaging in goal directed behavior --Poor concentration/ memory. Forgetfulness --Nonsensical logic --Difficulty understanding simple things --Thoughts, behavior, and actions are not integrated --Obsessive compulsive tendencies- with thoughts or actions --Thought insertion/ withdrawal- thoughts are put it or taken away without a conscious effort --Conversations that seem deep, but are not logical or coherent Examples of Delusions---- The most common type of delusion or false beliefs are paranoid delusions. These are persecutory in nature and take many forms: --Overpowering, intense feeling that people are talking about you, looking at you --Overpowering, intense feeling you are being watched, followed, and spied on (tracking devices, implants, hidden cameras) --Thinking that someone is trying to poison your food --Thinking people are working together to harass you --Thinking that something is controlling you- i.e. an electronic implant --Thinking that people can read your mind/ or control your thoughts --Thinking that your thoughts are being broadcast over the radio or tv --Delusions of reference- thinking that random events convey a special meaning to you. An example is that a newspaper headline or a license plate has a hidden meaning for you to figure out. That they are signs trying to tell you something. --Religious delusions- that you are Jesus, God, a prophet, or the antichrist. --Delusions of grandeur- the belief that you have an important mission, special purpose, or are an unrecognized genius, or famous person. --Delusions that someone, often a famous person, is in love with you when in reality they aren't. Also called erotomania or de Clerembault syndrome. Examples of Hallucinations---- --Hallucinations are as real as any other experience to the person with schizophrenia. As many as 70% hear voices, while a lesser number have visual hallucinations. --Auditory hallucinations can be either inside the person's head or externally. When external, they sound as real as an actual voice. Sometimes they come from no apparent source, other times they come from real people who don't actually say anything, other times a person will hallucinate sounds. --When people hear voices inside their heads, it is as if their inner thoughts are no longer alone. The new voices can talk to each other, talk to themselves, or comment on the person's actions. The majority of the time the voices are negative. --Visual hallucinations operate on a spectrum. They start with the overacuteness of the senses, then in the middle are illusions, and on the far end are actual hallucinations. Disclaimer: The following symptoms overlap with many other diseases such as bipolar disorder, major depression, the various kinds of personality disorders (specifically paranoid and schizotypal personality disorders), and other problems such as brain tumors and temporal lobe epilepsy. There is no "typical" case of schizophrenia. Everyone has different symptoms. Seek the opinion of your doctor always. Moreover, it is always important to keep the big picture in mind. Having just a few of these symptoms does not necessarily mean that a person has schizophrenia, or any other sort of psychiatric disorder. Almost all of the signs below can be present to a "normal" degree in people; it is when someone displays them to a significant degree that they can become psychiatric symptoms. Think if all of these behaviors as being on a continuum, in which the middle 99% of people displaying varying degrees of the behavior, but are still within the "normal" range. The 1% of people on the outer edges have the behaviors in extreme proportion, and/or a significant proportion of the time, and that is when they can become debilitating. A diagnosis of schizophrenia requires that continuous disturbance (i.e. debilitating symptoms) be present for at least six months, including at least one month of certain key symptoms (active symptoms: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms such as severe emotional flatness or apathy) Copyright 1996-2010. Schizophrenia.com. The Internet Mental Health Initiative, All Rights Reserved. http://schizophrenia.com/earlysigns.htm