Episodic-progredient/shiftlike childhood schizophrenia (malignant, paranoid and slow-progressive sub-types), continuous childhood schizophrenia, recurrent childhood schizophrenia (the rarest form – 5% of all cases)[2]
The disorder presents symptoms such as auditory and visual hallucinations, delusional thoughts or feelings, and abnormal behavior, profoundly impacting the child's ability to function and sustain normal interpersonal relationships. Delusions are often vague and less developed than those of adult schizophrenia, which features more systematized delusions.[7] Among the psychotic symptoms seen in childhood schizophrenia, non-verbal auditory hallucinations are the most common, and include noises such as shots, knocks, and bangs.[citation needed] Other symptoms can include irritability, searching for imaginary objects, low performance, and a higher rate of tactile hallucinations compared to adult schizophrenia. It typically presents after the age of seven.[8] About 50% of young children diagnosed with schizophrenia experience severe neuropsychiatric symptoms.[9] Studies have demonstrated that diagnostic criteria are similar to those of adult schizophrenia.[10][11] Neither DSM-5 nor ICD-11 list "childhood schizophrenia" as a separate diagnosis. The diagnosis is based on thorough history and exam by a child psychiatrist, exclusion of medical causes of psychosis (often by extensive testing), observations by caregivers and schools, and in some cases (depending on age) self reports from pediatric patients.
Classification of mental disorders
Diagnostic and Statistical Manual of Mental Disorders
Childhood schizophrenia was not directly added to the DSM until 1968, when it was added to the DSM-II,[12] which set forth diagnostic criteria similar to that of adult schizophrenia.[13] "Schizophrenia, childhood type" was a DSM-II diagnosis with diagnostic code 295.8,[12] equivalent to "schizophrenic reaction, childhood type" (code 000-x28) in DSM-I (1952).[12] "Schizophrenia, childhood type" was successfully removed from the DSM-III (1980), and in the Appendix C they wrote: "there is currently no way of predicting which children will develop Schizophrenia as adults". Instead of childhood schizophrenia they proposed to use of "infantile autism" (299.0x) and "childhood onset pervasive developmental disorder" (299.9x).[14]
In the DSM-III-R (1987), DSM-IV (1994), DSM-IV-TR (2000), DSM-5 (2013) there is no "childhood schizophrenia". The rationale for this approach was that, since the clinical pictures of adult schizophrenia and childhood schizophrenia are identical, childhood schizophrenia should not be a separate disorder.[15] However, the section in schizophrenia's Development and Course in DSM-5, includes references to childhood-onset schizophrenia.[1]
International Classification of Diseases
In the International Classification of Diseases 8th revision (ICD-8, 1967) there was a category (295.8) "Other" in the schizophrenia section (295). "Other" includes: atypical forms of schizophrenia, infantile autism, schizophrenia, childhood type, NOS (Not Otherwise Specified), schizophrenia of specified type not classifiable under 295.0–295.7, schizophreniform attack or psychosis.
Unspecified psychoses with origin specific to childhood (code 299.9) in the International Classification of Diseases 9th revision (ICD-9) includes "child psychosis NOS", "schizophrenia, childhood type NOS" and "schizophrenic syndrome of childhood NOS".[16]
"Childhood type schizophrenia" available in the Soviet adopted version of the ICD-9 (code 299.91) and the Russian adopted version of the 10th revision ICD-10 (code F20.8xx3)[17] and the U.S. adopted the 10th revision ICD-10 (code F20.9x6) classified "schizophrenia, unspecified".[18]
Schizophrenia is a mental disorder that is expressed in abnormal mental functions, a loss of one's sense of identity and self, a compromised perception of reality, and disturbed behavior.
The signs and symptoms of childhood schizophrenia are similar to those of adult-onset schizophrenia. Some of the earliest signs that a young child may develop schizophrenia are lags in language and motor development. Some children engage in activities such as flapping the arms or rocking, and may appear anxious, confused, or disruptive on a regular basis. Children may experience hallucinations, but these are often difficult to differentiate from just normal imagination or child play. Visual hallucinations are more commonly found in children than in adults.[1] It is often difficult for children to describe their hallucinations or delusions, making very early-onset[19] schizophrenia especially difficult to diagnose in the earliest stages. The cognitive abilities of children with schizophrenia may also often be lacking, with 20% of patients showing borderline or full intellectual disability.[20]
Apathy is an overall lack of interest or enjoyment, which relates to the negative symptom of blunted emotional affect.
Blunted emotional affect includes a lack of facial expressions, lack of intonation while speaking, and little eye contact. If you are speaking to someone who has blunted emotional affect, it would be difficult to determine their feelings using their facial expressions and tone.
Avolition is experienced when the child shows few goal-focused behaviors and choices, and a lack of interest in goal-related activities, including personal hygiene.[21]
Alogia can be seen when people use few words and lack fluency while speaking.
Anhedonia relates to an inability to find pleasure in activities that one previously found enjoyable, as well as the inability to remember previous enjoyable memories.[22]
Asociality is a symptom seen when a person has no interest in socializing with others.[23]
These negative symptoms can severely impact children's and adolescents' abilities to function in school and in other public settings.
Very early-onset schizophrenia refers to onset before the age of thirteen. The prodromal phase, which precedes psychotic symptoms, is characterized by deterioration in school performance, social withdrawal, disorganized or unusual behavior, a decreased ability to perform daily activities, a deterioration in self-care skills, bizarre hygiene and eating behaviors, changes in affect, a lack of impulse control, hostility and aggression, and lethargy.[20]
Auditory hallucinations are the most common of the positive symptoms in children. Auditory hallucinations may include voices that are conversing with each other or voices that are speaking directly to the children themselves. Many children with auditory hallucinations believe that if they do not listen to the voices, the voices will harm them or someone else. Tactile and visual hallucinations seem relatively rare. Children often attribute the hallucinatory voices to a variety of beings, including family members or other people, evil forces ("the Devil", "a witch", "a spirit"), animals, characters from horror movies (Bloody Mary, Freddy Krueger) and less clearly recognizable sources ("bad things," "the whispers").[11] Delusions are reported in more than half of children with schizophrenia, but they are usually less complex than those of adults.[11] Delusions are often connected with hallucinatory experiences.[11] Command auditory hallucinations (also known as imperative hallucinations) were common and experienced by more than half of the group in a study at Bellevue Hospital Center's Children's Psychiatric Inpatient Unit.[11] In this study, delusions were characterized as persecutory for the most part, but some children reported delusions of control.[11] Many said they were being tortured by the beings causing their visual and auditory hallucinations; some thought disobeying their voices would cause them harm.[11]
Some degree of thought disorder was observed in a test group of children at Bellevue Hospital. They displayed illogicality, tangentiality (a serious disturbance in the associative thought process), and loosening of associations.[24]
Several environmental factors, including perinatal complications and prenatal maternal infections may contribute to the etiology of schizophrenia.[10] Prenatal rubella or influenza infections are associated with childhood-onset schizophrenia.[25] Severity or frequency of prenatal infections may also contribute to earlier onset of symptoms by means of congenital brain malformations, reduction or impairment of cognitive function, and psychological disorders.[26][25] It is believed that prenatal exposure to rubella modifies the developmental course during childhood, increasing the risk for childhood schizophrenia.[25] Genetic predisposition is an important factor as well; familial mental illness is more frequently reported for childhood-onset schizophrenic patients.[27] While it is hard to detect, there are relatives who are more-likely to be diagnosed with schizophrenia if they are children of individuals who have this disorder. "First degree relatives" are found to have the highest chance of being diagnosed with schizophrenia. Children of individuals with schizophrenia have a 8.2% chance of having schizophrenia while the general population is at an 0.86% chance of having this disorder.[28] These results indicate that genes play a big role in one developing schizophrenia.
Genetic
There is "considerable overlap" in the genetics of childhood-onset and adult-onset schizophrenia, but in childhood-onset schizophrenia there is a higher number of "rare allelic variants".[29] There have been several genes indicated in children diagnosed with schizophrenia that include: neuregulin, dysbindin, D-amino acid oxidase, proline dehydrogenase, catechol-Omethyltransferase, and regulator of G protein signaling. There have also been findings of 5HT2A and dopamine D3 receptor. An important gene for adolescent-onset schizophrenia is the catechol-O-methyltransferase gene, a gene that regulates dopamine.[30] Children with schizophrenia have an increase in genetic deletions or duplication mutations[31] and some have a specific mutation called 22q11 deletion syndrome, which accounts for up to 2% of cases.[32][33]
Neuroanatomical
Neuroimaging studies have found differences between the medicated brains of individuals with schizophrenia, and the brains of those without, though research does not know the cause of the difference.[34] In childhood-onset schizophrenia, there appears to be a more rapid loss of cerebral grey matter during adolescence.[34][35] Studies have reported that adverse childhood experiences (ACEs) are the most preventable cause of the development of psychiatric disorders such as schizophrenia. ACEs have the potential to impact on the structure and function of the brain; structural changes revealed have been related to stress. Findings also report that different areas of the brain are affected by different types of maltreatment.[36]
In 2013, the American Psychiatric Association released the fifth edition of the DSM (DSM-5). According to the manual, to be diagnosed with schizophrenia, two diagnostic criteria have to be met over much of the time of a period of at least one month, with a significant impact on social or occupational functioning for at least six months. The DSM diagnostic criteria outlines that the person has to be experiencing either delusions, hallucinations, or disorganized speech. In other words, an individual does not have to be experiencing delusions or hallucinations to receive a diagnosis of schizophrenia. A second symptom could be negative symptoms, or severely disorganized or catatonic behavior.[37] Only two symptoms are required for a diagnosis of schizophrenia, resulting in different presentations for the same disorder.[37]
In practice, agreement between the two systems is high.[38] The DSM-5 criteria puts more emphasis on social or occupational dysfunction than the ICD-10.[39] The ICD-10, on the other hand, puts more emphasis on first-rank symptoms.[40][41] The current proposal for the ICD-11 criteria for schizophrenia recommends adding self-disorder as a symptom.[42]
Changes made
Both manuals have adopted the chapter heading of Schizophrenia spectrum and other psychotic disorders; ICD modifying this as Schizophrenia spectrum and other primary psychotic disorders.[43] The definition of schizophrenia remains essentially the same as that specified by the 2000 text revised DSM-IV (DSM-IV-TR). However, with the publication of DSM-5, the APA removed all sub-classifications of schizophrenia.[43] ICD-11 has also removed subtypes. The removed subtype from both, of catatonic has been relisted in ICD-11 as a psychomotor disturbance that may be present in schizophrenia.[43]
Another major change was to remove the importance previously given to Schneider's first-rank symptoms.[44] DSM-5 still uses the listing of schizophreniform disorder but ICD-11 no longer includes it.[43] DSM-5 also recommends that a better distinction be made between a current condition of schizophrenia and its historical progress, to achieve a clearer overall characterization.[44]
A dimensional assessment has been included in DSM-5 covering eight dimensions of symptoms to be rated (using the Scale to Assess the Severity of Symptom Dimensions) – these include the five diagnostic criteria plus cognitive impairments, mania, and depression.[43] This can add relevant information for the individual in regard to treatment, prognosis, and functional outcome; it also enables the response to treatment to be more accurately described.[43][45]
First-rank symptoms are psychotic symptoms that are particularly characteristic of schizophrenia, which were put forward by Kurt Schneider in 1959.[46] Their reliability for the diagnosis of schizophrenia has been questioned since then.[47] A 2015 systematic review investigated the diagnostic accuracy of first rank symptoms:
These studies were of limited quality. Results show correct identification of people with schizophrenia in about 75–95% of the cases although it is recommended to consult an additional specialist. The sensitivity of FRS was about 60%, so it can help diagnosis and, when applied with care, mistakes can be avoided. In lower resource settings, when more sophisticated methods are not available, first rank symptoms can be very valuable.[48]
Summary accuracy% (95% CI)
Prevalence median (range)
Implications
Quality and comments
Diagnosis of schizophrenia from all other diagnoses
Prevalence of 48%: 48 out of every 100 people with all other mental health diagnoses will have schizophrenia. The result means that, of these, 21 will not be identified as having schizophrenia by use of FRS (43% of 48). Then, of the 52 people really without schizophrenia, 10 may be incorrectly diagnosed with schizophrenia by the FRS.
Diagnosis of schizophrenia from other types of psychosis
Prevalence of 57%: 57 out of every 100 people with other types of psychosis will have schizophrenia. The result means that, of these, 24 will not be identified as having schizophrenia by use of FRS (42% of 57). Then, of the 43 people really without schizophrenia, 13 may be incorrectly diagnosed with schizophrenia by the FRS.
For all three estimates there are important issues regarding patient selection, use of index test and reference standard. This raises doubts about the accuracy of these findings. Also most studies were not conducted in an everyday clinical setting.
Diagnosis of schizophrenia from non-psychotic disorders
With a prevalence of 55%, 55 out of every 100 people with non-psychotic disorders will have schizophrenia. Of these, 21 will not be identified as having schizophrenia by use of FRS (38% of 55). Then, of the 45 people really without schizophrenia, 3 may be incorrectly diagnosed with schizophrenia by the FRS.
The same criteria are used to diagnose children and adults.[10][11] Diagnosis is based on reports by parents or caretakers, teachers, school officials, and others close to the child.
A professional who believes a child has schizophrenia usually conducts a series of tests to rule out other causes of behavior, and pinpoint a diagnosis. Three different types of study are performed: physical, laboratory, and psychological. Physical exams usually cover the basic assessments, including but not limited to; height, weight, blood pressure, and checking all vital signs to make sure the child is healthy.[49] Laboratory tests include electroencephalogram EEG screening and brain imaging scans. Blood tests are used to rule out alcohol or drug effects,[49] and thyroid hormone levels are tested to rule out hyper- or hypothyroidism.[medical citation needed] A psychologist or psychiatrist talks to a child about their thoughts, feelings, and behavior patterns. They also inquire about the severity of the symptoms, and the effects they have on the child's daily life. They may also discuss thoughts of suicide or self-harm in these one-on-one sessions.[49] Some symptoms that may be looked at are early language delays, early motor development delays, and school problems.[49]
Childhood schizophrenia manifests before the age of 13 and is also known as very early-onset schizophrenia. Onset before the age of 18 is known as early-onset schizophrenia, and is rare; very early-onset is even rarer with a frequency of 1 in 40,000.[50]
Differential diagnosis
The onset of childhood schizophrenia usually follows a period of normal, or near normal, development.[51] Strange interests, unusual beliefs, and social impairment can be prodromal symptoms of childhood schizophrenia, but can also be signs of autism spectrum disorder.[51] Hallucinations and delusions are typical for schizophrenia, but not features of autism spectrum disorder.[51] In children hallucinations must be separated from typical childhood fantasies.[51] Since childhood disintegrative disorder (CDD) has a very similar set of symptoms and high comorbidity it can be misdiagnosed as childhood schizophrenia, which can lead to prescribing ineffective medications.[52]
Childhood schizophrenia can be difficult to diagnosis simply because of how many disorders mimic the symptoms of CS. Though it can be difficult, that is why it is important to examine the whole mental state of the child at that time. Individuals who experience disorders such as major depressive disorder, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, delusional disorder and schizotypal personality disorder have all been known to exhibit similar symptoms to children who have been diagnosed with CS.[53]
The three most common disorders that are difficult to distinguish are bipolar disorder (BD), autism spectrum disorder (ASD), and attention deficit hyperactive disorder (ADHD). BD, ASD, and ADHD overlap with symptom patterns in CS [53] but a few distinguishing factors helps differentiate the disorders. Understanding these differences is crucial to diagnosing the child.
Individuals with bipolar disorder and childhood schizophrenia can both present psychotic symptoms such as hallucinations, delusions, and disorganized behaviors.[53] A distinguishing feature in childhood schizophrenia, the hallucination, aren't taking place during a 'depressive or manic' episode as it would for an individual diagnosed with bipolar disorder. An individual with bipolar disorder has both low and high moods while one with CS, exhibits elements of depression.[53]
Autism spectrum disorder share many features that are present in CS such as disorganized speech, social deficits, and extremely bizarre and repetitive behaviors.[53] A hallmark of CS and distinguishing factor is when hallucinations last longer than one month. Should this occur, further examinations are necessary to determine if the child has ASD or CS.
Unlike the previous two disorders, ADHD and CS have fewer commonalities.[53] Both individuals who have been diagnosed with CS and ADHD may appear to exhibit a poor attention span and disorganization. "Psychotic episodes are absent in ADHD, a distinct difference from CS".
It is important to understand that children diagnosed with childhood schizophrenia have higher rates of comorbidity, so exploring all resources is necessary to properly diagnose the child.[53]
Research efforts are focusing on prevention in identifying early signs from relatives with associated disorders similar to schizophrenia and those with prenatal and birth complications. Prevention has been an ongoing challenge because early signs of the disorder are similar to those of other disorders. Also, some of the schizophrenic-related symptoms are often found in children without schizophrenia or any other diagnosable disorder.[54]
Treatment
Current methods in treating early-onset schizophrenia follow a similar approach to the treatment of adult schizophrenia. Although methods of treatment for childhood schizophrenia are largely understudied, the use of antipsychotic medicine is normally the primary line of treatment in addressing signs in childhood schizophrenia diagnoses. Contemporary practices of schizophrenia treatment are multidisciplinary, recuperation oriented, and consist of medications, with psychosocial interventions that include familial support systems.[55] However, research has shown that atypical antipsychotics may be preferable because they cause less short-term side effects.[56] When weighing treatment options, it is necessary to consider the adverse effects, such as metabolic syndrome,[57] of various medications used to treat schizophrenia and the potential implications of these effects on development.[58] A 2013 systematic review compared the efficacy of atypical antipsychotics versus typical antipsychotics for adolescents:
Atypical compared with typical antipsychotics (only short term)[59]
Summary
There is not any convincing evidence suggesting that atypical antipsychotic medications are superior to the older typical medications for the treatment of adolescents with psychosis. However, atypical antipsychotic medications may be more acceptable because fewer symptomatic adverse effects are seen in the short term. Little evidence is available to support the superiority of one atypical antipsychotic medication over another.[59]
Outcome
Findings in words
Findings in numbers
Quality of evidence
Global state
Worse or no improvement
There is no clear difference between the newer atypical antipsychotic drugs and the typical drugs for this global outcome. These findings are based on data of low quality.
Atypical probably reduces the chance of experiencing dry mouth, constipation, and blurred vision but often doses of the older drugs are such that these type of adverse effects are to be expected. Lower doses of control drug could have offset this risk. Data are based on moderate quality evidence.
Use of atypical drugs may increase the chance of leaving early because of adverse effects, but the difference between the treatments is not clear. Data supporting this finding are based on moderate quality evidence.
A very-early diagnosis of schizophrenia leads to a worse prognosis than other psychotic disorders.[61] The primary area that children with schizophrenia must adapt to is their social surroundings. It has been found, however, that very early-onset schizophrenia carried a more severe prognosis than later-onset schizophrenia. Regardless of treatment, children diagnosed with schizophrenia at an early age have diminished social skills, such as educational and vocational abilities.[62]
The grey matter in the cerebral cortex of the brain shrinks over time in people with schizophrenia; the question of whether antipsychotic medication exacerbates or causes this has been controversial. A 2015 meta-analysis found that there is a positive correlation between the cumulative amount of first generation antipsychotics taken by people with schizophrenia and the amount of grey matter loss, and a negative correlation with the cumulative amount of second-generation antipsychotics taken.[63][64]
Epidemiology
Schizophrenia disorders in children are rare.[8] Boys are twice as likely to be diagnosed with childhood schizophrenia.[65] There is often a disproportionately large number of males with childhood schizophrenia, because the age of onset of the disorder is earlier in males than females by about 5 years.[5] Clinicians have been and still are reluctant to diagnose schizophrenia early on, primarily due to the stigma attached to it.[54]
While very early-onset schizophrenia is a rare event, with prevalence of about 1:40,000, early-onset schizophrenia manifests more often, with an estimated prevalence of 0.5%.[60]
History
Until the late nineteenth century, children were often diagnosed with psychosis like schizophrenia, but instead were said to have "pubescent" or "developmental" insanity. Through the 1950s, childhood psychosis began to become more and more common, and psychiatrists began to take a deeper look into the issue.[13][failed verification]
Sante De Sanctis first wrote about child psychoses, in 1905. He called the condition "dementia praecocissima" (Latin, "very premature madness"), by analogy to the term then used for schizophrenia, "dementia praecox" (Latin, "premature madness).[66] De Sanctis characterized the condition by the presence of catatonia.[67]Philip Bromberg thinks that "dementia praecocissima" is in some cases indistinguishable from childhood schizophrenia; Leo Kanner believed that "dementia praecocissima" encompassed a number of pathological conditions.[67]
Theodor Heller discovered a new syndrome dementia infantilis (Latin, "infantile madness") in 1909 which was named Heller syndrome.[68] In ICD-11 Heller syndrome is classed as an autism spectrum subtype.[69]
A 1913 paper by Karl Pönitz, "Contribution to the Recognition of Early Catatonia",[70] recounts a case study of a boy who manifested "typical catatonia" from the age of twelve, characterizing him as showing a "clear picture of schizophrenia."[68]
Catatonia is a complex syndrome, most commonly seen in people with underlying mood disorders, such as major depressive disorder, or psychotic disorders, such as schizophrenia. People with catatonia have abnormal movement and behaviors, which vary from person to person and fluctuate in intensity within a single episode. People with catatonia appear withdrawn, meaning that they do not interact with the outside world and have difficulty processing information. They may be nearly motionless for days on end or perform repetitive purposeless movements. Two people may exhibit very different sets of behaviors and both still be diagnosed with catatonia. Treatment with benzodiazepines or ECT are most effective and lead to remission of symptoms in most cases.
Psychosis is a condition of the mind or psyche that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are disorganized thinking and incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
Schizophrenia is a mental disorder characterized variously by hallucinations, delusions, disorganized thinking and behavior, and flat or inappropriate affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially mood, anxiety, and substance use disorders, as well as obsessive–compulsive disorder (OCD).
The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), was a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. It was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the International Classification of Diseases (ICD).
Schizoaffective disorder is a mental disorder characterized by symptoms of both schizophrenia (psychosis) and a mood disorder - either bipolar disorder or depression. The main diagnostic criterion is the presence of psychotic symptoms for at least two weeks without prominent mood symptoms. Common symptoms include hallucinations, delusions, disorganized speech and thinking, as well as mood episodes. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses. Many people with schizoaffective disorder have other mental disorders including anxiety disorders.
A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, paralogia, word salad, and delusions—all disturbances of thought content and form. Two specific terms have been suggested—content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as it is known today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."
Stimulant psychosis is a mental disorder characterized by psychotic symptoms. It involves and typically occurs following an overdose or several day binge on psychostimulants, although it can occur in the course of stimulant therapy, particularly at higher doses. One study reported occurrences at regularly prescribed doses in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy. Methamphetamine psychosis, or long-term effects of stimulant use in the brain, depend upon genetics and may persist for months or years. Psychosis may also result from withdrawal from stimulants, particularly when psychotic symptoms were present during use.
Thought broadcasting is a type of delusional condition in which the affected person believes that others can hear their inner thoughts, despite a clear lack of evidence. The person may believe that either those nearby can perceive their thoughts or that they are being transmitted via mediums such as television, radio or the internet. Different people can experience thought broadcasting in different ways. Thought broadcasting is most commonly found among people who have a psychotic disorder, specifically schizophrenia.
Schizophreniform disorder is a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of time, but signs of disturbance are not present for the full six months required for the diagnosis of schizophrenia.
Paraphrenia is a mental disorder characterized by an organized system of paranoid delusions with or without hallucinations and without deterioration of intellect or personality.
A spectrum disorder is a disorder that includes a range of linked conditions, sometimes also extending to include singular symptoms and traits. The different elements of a spectrum either have a similar appearance or are thought to be caused by the same underlying mechanism. In either case, a spectrum approach is taken because there appears to be "not a unitary disorder but rather a syndrome composed of subgroups". The spectrum may represent a range of severity, comprising relatively "severe" mental disorders through to relatively "mild and nonclinical deficits".
Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a rare mental disorder in children and adolescents. The diagnosis of bipolar disorder in children has been heavily debated for many reasons including the potential harmful effects of adult bipolar medication use for children. PBD is similar to bipolar disorder (BD) in adults, and has been proposed as an explanation for periods of extreme shifts in mood called mood episodes. These shifts alternate between periods of depressed or irritable moods and periods of abnormally elevated moods called manic or hypomanic episodes. Mixed mood episodes can occur when a child or adolescent with PBD experiences depressive and manic symptoms simultaneously. Mood episodes of children and adolescents with PBD are different from general shifts in mood experienced by children and adolescents because mood episodes last for long periods of time and cause severe disruptions to an individual's life. There are three known forms of PBD: Bipolar I, Bipolar II, and Bipolar Not Otherwise Specified (NOS). The average age of onset of PBD remains unclear, but reported age of onset ranges from 5 years of age to 19 years of age. PBD is typically more severe and has a poorer prognosis than bipolar disorder with onset in late-adolescence or adulthood.
The classification of mental disorders, also known as psychiatric nosology or psychiatric taxonomy, is central to the practice of psychiatry and other mental health professions.
Child and adolescent psychiatry is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children, adolescents, and their families. It investigates the biopsychosocial factors that influence the development and course of psychiatric disorders and treatment responses to various interventions. Child and adolescent psychiatrists primarily use psychotherapy and/or medication to treat mental disorders in the pediatric population.
Brief psychotic disorder—according to the classifications of mental disorders DSM-IV-TR and DSM-5—is a psychotic condition involving the sudden onset of at least one psychotic symptom lasting 1 day to 1 month, often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to the previous level of functioning. It may follow a period of extreme stress including the loss of a loved one. Most patients with this condition under DSM-5 would be classified as having acute and transient psychotic disorders under ICD-10. Prior to DSM-IV, this condition was called "brief reactive psychosis." This condition may or may not be recurrent, and it should not be caused by another condition.
Postpartum psychosis (PPP), also known as puerperal psychosis or peripartum psychosis, involves the abrupt onset of psychotic symptoms shortly following childbirth, typically within two weeks of delivery but less than 4 weeks postpartum. PPP is a condition currently represented under "Brief Psychotic Disorder" in the Diagnostic and Statistical Manual of Mental Disorders, Volume V (DSM-V). Symptoms may include delusions, hallucinations, disorganized speech, and/or abnormal motor behavior. Other symptoms frequently associated with PPP include confusion, disorganized thought, severe difficulty sleeping, variations of mood disorders, as well as cognitive features such as consciousness that comes and goes or disorientation.
The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States.
Simple-type schizophrenia is a sub-type of schizophrenia included in the International Classification of Diseases (ICD-10), in which it is classified as a mental and behaviour disorder. It is not included in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the upcoming ICD-11, effective 1 January 2022. Simple-type schizophrenia is characterized by negative ("deficit") symptoms, such as avolition, apathy, anhedonia, reduced affect display, lack of initiative, lack of motivation, low activity; with absence of hallucinations or delusions of any kind.
Bouffée délirante (BD) is an acute and transient psychotic disorder. It is a uniquely French psychiatric diagnostic term with a long history in France and various French speaking nations: Caribbean, e.g., Haiti, Guadeloupe, Antilles and Francophone Africa. The term BD was originally coined and described by Valentin Magnan (1835–1916), fell into relative disuse and was later revived by Henri Ey (1900–1977).
The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) is a semi-structured interview aimed at early diagnosis of affective disorders such as depression, bipolar disorder, and anxiety disorder. There are different versions of the test that have use different versions of diagnostic criteria, cover somewhat different diagnoses and use different rating scales for the items. All versions are structured to include interviews with both the child and the parents or guardians, and all use a combination of screening questions and more comprehensive modules to balance interview length and thoroughness.
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