Practitioner Review: Psychosis in children and adolescents

Psychotic symptoms, including hallucinations, delusions, and disorganized thinking and behaviors, are the hallmarks of schizophrenia; but may also present in the context of other psychiatric and medical conditions. Many children and adolescents describe psychotic-like experiences, which can be associated with other types of psychopathology and past experiences (e.g., trauma, substance use, and suicidality). However, most youth reporting such experiences do not have, nor will ever develop, schizophrenia or another psychotic disorder. Accurate assessment is critical because these different presentations have different diagnostic and treatment implications. For this review, we focus primarily on the diagnosis and treatment of early onset schizophrenia. In addition, we review the development of community-based first-episode psychosis programming, and the importance of early intervention and coordinated care.

Automated summary

Psychotic symptoms, such as hallucinations, delusions, and disorganized thinking and behaviors, are characteristic of schizophrenia but can occur in other psychiatric and medical conditions. Many children and adolescents experience psychotic-like symptoms, which may be linked to other psychopathology and past experiences. However, most youth reporting such symptoms do not have or develop schizophrenia or another psychotic disorder. Accurate assessment is crucial as different presentations have different diagnostic and treatment implications. This review focuses on the diagnosis and treatment of early onset schizophrenia, as well as the development of community-based first-episode psychosis programs and the importance of early intervention and coordinated care.