24. Psychotic Disorders

  1. William M. Klykylo3 and
  2. Jerald Kay4
  1. Michael T. Sorter1 and
  2. Daniel A. Vogel2

Published Online: 30 MAR 2012

DOI: 10.1002/9781119962229.ch24

Clinical Child Psychiatry, Third Edition

Clinical Child Psychiatry, Third Edition

How to Cite

Sorter, M. T. and Vogel, D. A. (2012) Psychotic Disorders, in Clinical Child Psychiatry, Third Edition (eds W. M. Klykylo and J. Kay), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781119962229.ch24

Editor Information

  1. 3

    Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

  2. 4

    Department of Psychiatry, Wright State University School of Medicine, P.O. Box 927, Dayton, OH 45401-0927, USA

Author Information

  1. 1

    Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, M.L. 3014, Cincinnati, OH 45229, USA

  2. 2

    Cincinnati Children's Hospital Medical Center, 3333 Burnet avenue, MI 3014, Cincinnati, OH 45229-3014, USA

Publication History

  1. Published Online: 30 MAR 2012
  2. Published Print: 30 MAR 2012

ISBN Information

Print ISBN: 9781119993346

Online ISBN: 9781119962229

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Keywords:

  • psychosis;
  • schizophrenia;
  • reality testing;
  • delusion;
  • hallucination;
  • antipsychotic;
  • psychoeducation;
  • ultra-high-risk syndrome

Summary

Children or adolescents identified as suffering from psychosis, although varied in their presentations, struggle with simple adaptive functioning and suffer with cognitive, emotional, perceptual, and interpersonal difficulties. Psychosis has various definitions, all of which embody severe impairment of mental functioning with disturbance in reality testing – the ability to evaluate the nature of the external environment, to tell the difference between one's internal and external worlds, and to accurately evaluate the relationship between oneself and the environment. Although psychotic symptoms are a prominent manifestation of various illnesses, early-onset schizophrenia is the primary topic considered in this chapter. We set the diagnosis of childhood schizophrenia in its historical context, summarize the current data on prevalence and epidemiology, and detail the premorbid and morbid features. The etiology of schizophrenia remains unknown; many investigators regard schizophrenia as a final common disease state perhaps with multiple possible etiologies. We examine the possible contributions of genetics, neurobiological deficits, family, and environment. The proper assessment of a child or adolescent with psychosis requires an evaluation of all areas of functioning, and careful consideration of possible differential diagnoses. Treatment requires a comprehensive multimodal approach, with the goals of decreasing the characteristic psychotic symptomatology, returning the child to more appropriate lines of development, and reintegrating the child into his or her home and community. A variety of approaches are available, including medical, psychiatric, and community resources along with supportive and educational intervention by the family. We summarize the results of key outcome studies, and also look at the identification of a high-risk group of patients who have an enhanced risk for development of psychosis.