Private diagnosis for schizophrenia?

[YouAreMyRain]

It's me again.
I have posted a similar thread in children's MH on here but there's not much traffic.
I thought some people on this area may (unfortunately) be able to help.

I have two adopted DD. DD1 is 8yo, under Camhs, lots of MH issues. We have had a horrendous few days with her trying to drown her sister (6yo) in the bath and saying that she wasn't angry, she just had a "feeling" that she "had to hold her head under the water until she stopped breathing".
I have spoken to Camhs and PAS, who were considering removing her as a risk to the other children (I have a one yr old DS who she has previously threatened) but have changed their mind.

Anyway, the main reason for this thread is that I am concerned that she is showing early signs of schizophrenia or a personality disorder.

Camhs in our area have said that they would not diagnose either of these until late teens or early twenties as the personality is still fluid until then.

I would be happy to pay privately as she may need meds and specialist treatment etc but I don't know how to find a private child psychiatrist who would do so. Any thoughts?

Teratogenic substances in utero do have physical consequences (as evidenced by facial features) and this is why it's important to look at neurodevelopment - there may have been damage to the brain or nervous system like epilepsy so it needs to be looked at from a medical viewpoint as well as a pscyhological one.

There ought to be enough information on the files to know what kind of substances the mother was taking - if not they should be able to ask her as each substance would have a slightly different effect.

I agree with Munchkin that there is no one solution but I would have thought it's essential to rule these things out before any strategies and approaches are decided on and it might be the reason that CAMHS aren't progressing. The NDA needs to come first and if necessary, a CT scan or MRI. Terrible trauma can cause terrible symptoms but this sounds like it's something else.

Thanks all. DDs birth mum was definitely taking crack cocaine throughout the pregnancy and when we met her she told us that she was kicked in the stomach while pregnant.

Excellent email. I think that is just what you need everyone to agree a coherent strategy to help DD1 and keep the whole family safe.

I'm sure you looked up the effects of crack cocaine in utero, and it seems to be that one of the effects is stroke, not just at birth and shortly after, but in the womb. It's a very different effect to alcohol, which sits in the liver. The physical abuse may or may not have given brain damage, all the more reason to get an MRI and a CT scan, there are new scans that can also show more. I'm not an expert, I just looked this up but it supports my hunch that neurological as well as neurodevelopmental assessments are going to help if not find the exact cause of the problems, at least rule out some of them.

Rain how are you doing?

Ok, just tired.

DD did a strange thing earlier. I was in the toilet, DP was downstairs with all three DC. I came out of the bathroom and the baby was alone crawling around on the landing. There is no stairgate upstairs yet.

DD had got the baby, taken him upstairs, left him alone on the landing and gone back downstairs without saying anything. She hadn't told DP what she was doing, she hadn't shouted out to me to watch him. She knows he can't be left alone upstairs . She had no explanation for her actions. DP thought she was taking him into the back room,

It was very odd and obviously put the baby at risk.

Oh Rain, I am sorry that is not good. Did you ask her why she did it?

I have been thinking about risk, and I think a risk was mentioned up thread about the use of general anaesthetic.

I found this, and of course it is about operations etc but does include about general anaesthetic.

www.patient.co.uk/health/your-childs-general-anaesthetic

"In modern anaesthesia, serious problems are uncommon. Risk cannot be removed completely, but modern equipment, training and drugs have made it a much safer procedure in recent years.

Most children recover quickly and are soon back to normal after their operation and anaesthetic. Some children may suffer side effects like sickness or a sore throat. These usually last only a short time and there are medicines available to treat them if necessary.

The exact likelihood of complications depends on your child’s medical condition and on the nature of the surgery and anaesthesia your child needs. The anaesthetist can discuss this with you in detail at the pre-operative visit.

For a child in good health having minor surgery:

1 child in 10 (like one person in a large family) might experience a headache, sore throat, sickness or dizziness.
1 child in 100 (like one person in a street) might be mildly allergic to one of the drugs that has been given.
1 child in 20,000 (like one person in a small town) might develop a serious reaction (allergy) to the anaesthetic

Throughout the whole of life, an individual is at least 100 times more likely to suffer serious injury or death in a road traffic accident than as a result of anaesthesia."*

If you think a general anaesthetic to have a brain scan is not a huge risk but may give some real benefits in helping your dd can you request this and see what the doctors think? I am sure they will not just give you one on your say so.

I really do not want to be morbid or scaremongering at all but you said your dd tried to commit suicide, not just thought about it or talked about it, but attempted to jump out of a window.

There is a charity I know of that works in the area of child suicide.

www.papyrus-uk.org/

I read some information on children’s suicide but it is quite hard to find up to date info and information from the UK.

www.education.com/reference/article/suicide-risk-children/

I think talking to a charity might help because I think they will take you seriously and might give advice. I am not sure they will be able to help you get to the bottom of anything but they might help you.

Anyway, Rain please, as always, ignore, me if you find my comments unhelpful.

Apparently DD thought that it would be a "nice surprise" for me to see the baby on the landing.

I think the risks of a GA would be worth it if it could help long term

Rain does your dd1 have any learning difficulties, could she be unaware of the risks of a baby on the landing?

What did you and DP do when you found ds on the landing?

Good luck for another day.

I screamed "Why is there a baby on the landing?!!!??!!!" Then when I found out that she had done it I told her that it was very dangerous because of no stair gate at the top and she must never do it again (guess what is top of my list for this weekend?!)

She has additional help at school (IEP) but comes across as fairly sharp at times. It is possible that there are areas of difficulty that we are unaware of but she has always been hyper aware of hazards, I used to joke that it was like having a mini health and safety officer around! It was very out of character for her to be unaware of the risk.

I really think the brain scan is a red herring. If you want to find out if she has cognitive issues you need to look from outside in. So neurodeveloememtal assx, educational/cognitive assx (iq tests) and neuropsychological assx (memory ,impulsivity, language etc)

If you of a scan and it shows a structural issue no one will be able to say what it means for sure. You could use the results to guide neuropsychological testing as above but that is a totally back to front approach. far more sensible for tests to be indicated by your concerns and observations.

Honestly she has no neurological symptoms (motor issues, balance, epilepsy etc) so no cause for a scan. This issue is a distraction.

munchkinmaster I ma not a medical person so I have no idea if a brain scan is a red herring but I was under the impression that a brain scan might show early signs of schizophrenia.

news.sciencemag.org/2009/09/brain-scans-schizophrenia

I am aware schizophrenia in children is very rare and no one at all wants to label a child unnecessarily but as Rain's thread is entitled 'Private diagnosis for schizophrenia?'

Then I thought something that may help to diagnose schizophrenia may help.

I am aware the thread has moved on and Rain is not actively looking for a diagnosis at this time but surely anything that helps to uncover what is going on in her dd1, without unnecessary risk to her dd1, is helpful? I also feel that hopefully doctors would not sanction this if it was not thought to be helpful to the child. But I wonder if they may withhold it, even if it would be helpful simply because of this 'issue' of worrying about labelling a child.

As i say, I am not medical and this may be a red herring, but if dd1 were my child, like Rain, I would be exploring every possible reason and as long as there is no real risk would be at least asking questions of medical professionals.

Good luck Rain, as ever ignore me if I am talking crapola! Things have been a bit exhausting here, nothing like what you are coping with but very tiring. My dd has talked of wanting to die and possibly of wanting to kill herself. I know she doesn't mean it and it is not the same but it is terrible to hear.

I'm going to stop posting about this. A brain scan is not a standard test for schizophrenia - your link does not suggest that it is.

By all means rain could talk to proffesionals about this but I wouldn't want her to fight for it when other assessments will be so much more helpful. Neither do I want her to get her hopes up for some miracle test.

I've made my point. I'm simply trying to be helpful.

munchkinmaster please do not stop posting! I really do not want to dissuade anyone else from posting, I would rather I stopped than someone else. I am not a medical person, I do not know what is or is not possible and I always say if my post are not helpful that the other person should ignore them. Please do not stop posting because of me, that would be unfair to rain as I am sure you have a lot to add.

Hi, I'm not off in a strop. I just meant I've said my piece about an MRI so won't mention it again and leave it at that (re MRI). No offence meant or taken.

Thanks Munch as I say I am not a medical person, just feel the desperation of the OP and want to help but my suggestions may be crap!

But do come back with ideas or words. We all have lots to add and I know from being the op of other threads just people reading if a help.

is a help...

Munchkin all I'm saying is that if there is a neurological problem that is similar to epilepsy or Tourrette's it is important to diagnose as the structural problem that shows up in the scan will assist the neurologist in both diagnosis and in medicating if that's what she needs. It could solve her problems in an instance - you just don't know.

Cocaine causes strokes in the fetus and that's very damaging for the brain.

I'm not saying that all the other stuff shouldn't be looked at but you can't rule the physical stuff out.

Sorry if I've pissed you off! I hope it's just a communication problem.

I'm not pissed off. I just disagree and don't want to keep on reiterating as not sure how that helps rain.

I said I wouldn't say anything again but ...... You diagnose epilepsy and Tourette's via their observable symptoms (and EEG for epilepsy).

Our knowledge of the brain is not brilliant even in this day and age and seeing a lesion on a scan wouldn't help diagnose anything on it's own.

By all means ask to see a neurologist but I think neurodeveloememtal assx and neuropsychological assx will be more helpful than a scan .

But I don't want to turn this thread into am argument about scans so I will say no more about it!

How are things going Rain?

I hope your day has been better. Mine has turned out very well and yesterday was crap. It is so hard (for me) to know what will result in a good or bad day!

Ok thanks. A SW has been allocated now so just waiting to see what they say.

Italian, your article is talking about high resolution functional MRI. This is very much a research tool - it's not something that could be done in the vast majority of hospitals, only in very specialist units. It actually needs the patient to be awake so that their response to triggers and stimuli can be observed. Even if this could be arranged, the answers would at best only be interpreted alongside all the other information about the patient - it wouldn't give any answers in isolation.

Rain I found this article written by someone with Tourette's gives an amazing view on how it feels to her and what has helped her moderate the effect it has on her:

www.xojane.com/healthy/i-have-tourette-syndrome-and-cbit-changed-my-life

Thank you sophiepotato I hadn't really taken on board how much this was new and not really realised how this would affect any use. My apologies Rain I don't want to muddy the waters.

sophiepotato what a brilliant article.

That is so interesting as a friend was just telling me about her daughter who had some sort of actions she did that drew attention to herself. These might mean the child was picked on and the therapist said to touch each of the tips of the four fingers to the thumb, one after the other. This was something that gave the hand something to do but was not very noticeable and would pass as relatively 'normal' behaviour.

When I looked into my dd thumb sucking one suggestion was to have something nice to hold onto like a velvet ribbon, which would distract from the thumb sucking.

It feels a bit like a distraction technique, which we all know as parents trying to sway children away from 'bad behaviour'.

Very interesting indeed.

Not going to add much, but want to say that my DD has very severe Tourettes, and an entirely normal brain on MRI scan.
Most psychiatric diagnoses are still clinical - made on symptom presentation - even though research might say there are differences found in sufferers brains.