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POST # 1 GINA
What are some of the presenting characteristics and manifestations of psychosis among adolescents and children? The presenting characteristics and manifestations of psychosis in the pediatric population can have a variety of causes. As with all psychiatric conditions, it is important to rule out any underlying medical conditions that might be present. Differential diagnosis of hypoglycemia, substance use, hypoxia, and other conditions that alter mental status must be ruled out (Babu & Boyer, 2020). Children may exhibit psychosis due to schizophrenia, unipolar depression, and bipolar disorders (Babu & Boyer, 2020). This population may have delusions, which are altered thinking not congruent with reality, and or hallucinations, or seeing, hearing, touching, or smelling something that is not there. While some children and adolescents can have an acute onset of psychosis, it typically takes time to develop these symptoms, with warning signs that can be noted for years to months prior to psychosis. Attenuated psychosis syndrome can be seen for years in children and adolescents before they meet the criteria for schizophrenia for example (Taylor & Huque, 2021). Mild delusions and hallucinations, and speech that doesn't quite meet disorganized criteria are often found (Taylor & Huque, 2021). According to McClellan (2018), early signs of psychosis in the pediatric population may include issues with thinking such as bizarre speech; concerns with behavior such as withdrawing from others; and emotional irritability and depressed mood. Children and adolescents are less likely to have delusions and hallucinations when compared with adults (McClellan, 2018). Later you may see the presentation of delusions, hallucinations, disorganized speech, and negative symptoms (McClellan, 2018). References Babu, K. M., & Boyer, E. W. (2020, January 8). Emergency department evaluation of acute onset psychosis in children. UpToDate. Retrieved July 26, 2021 from https://www.uptodate.com/contents/emergency-department-evaluation-of-acute-onset-psychosis-in-children McClellan, J. (2018). Psychosis in Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 57(5), 308–312. https://doi.org/10.1016/j.jaac.2018.01.021 Taylor, J. H., & Huque, Z. M. (2021). Commentary: Schizophrenia prevention and prodromal psychosis in children and adolescents. Journal of Child Psychology & Psychiatry, 62(5), 674–676. https://doi.org/10.1111/jcpp.13408
RESOURCES
For additional background information on psychotic disorders in adolescents and children, review the following resources:
· Online resources such as NAMI (National Alliance in Mental Illness) and SAMHSA (Substance Abuse and Mental Health Services Administration). For instance, NAMI is one of the appropriate and essential resources that provide valuable information on mental health conditions including psychotic disorders. Review this resource by accessing https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions .
· SAMHSA is another useful resource that provides crucial and valuable information related to mental health disorders. Review this resource by accessing https://www.samhsa.gov/ .
You may also review the following articles .
· 1) Young children with psychotic symptoms and risk for suicidal thoughts and behaviors: a research note Keneisha Sinclair-McBride, Nicholas Morelli, Sahil Tembulkar, Kelsey Graber, Joseph Gonzalez-Heydrich, & Eugene J. D’Angelo. (2018). Young children with psychotic symptoms and risk for suicidal thoughts and behaviors: a research note. BMC Research Notes, 11(1), 1–5. https://doi.org/10.1186/s13104-018-3680-3
· 2) Psychotic Disorders in Children and Adolescents: A Primer on Contemporary Evaluation and Management Stevens, J. R., Prince, J. B., Prager, L. M., & Stern, T. A. (2014). Psychotic disorders in children and adolescents: a primer on contemporary evaluation and management. The primary care companion for CNS disorders, 16(2), PCC.13f01514. https://doi.org/10.4088/PCC.13f01514
· 3) Evaluation and Treatment of Children and Adolescents with Psychotic Symptoms
· Algon, S., Yi, J., Calkins, M. E., Kohler, C., & Borgmann-Winter, K. E. (2012). Evaluation and treatment of children and adolescents with psychotic symptoms. Current psychiatry reports, 14(2), 101–110. https://doi.org/10.1007/s11920-012-0258-y
· 4) Medical evaluation of psychotic symptoms in children and adolescents: Key approaches.