Early-onset psychosis is linked to adverse long-term outcomes, recurrent disease course, and prolonged periods of untreated illness; thus highlighting the urgency of improving early identification and intervention. This paper discusses three cases where initial emphasis on psychosocial treatments led to diagnostic and therapeutic delays: (1) a 15-year-old misdiagnosed with emotionally unstable personality disorder and autism, who improved on bipolar medication and antipsychotics; (2) another 15-year-old misdiagnosed with autism, who stabilized on lithium and antipsychotics, subsequently allowing for gender dysphoria evaluation; (3) a 9-year-old autistic boy incorrectly treated for ADHD, who recovered with appropriate antipsychotic treatment. These cases illuminate the vital importance of adhering to a diagnostic hierarchy, prioritizing diagnostic utility, and conducting longitudinal evaluations to facilitate early targeted treatment of psychotic symptoms in early-onset psychosis. Adherence to such strategies can minimize delays in managing early-onset psychosis and improve long-term prognoses.
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http://dx.doi.org/10.1038/s41537-023-00427-z | DOI Listing |
J Affect Disord
January 2025
Service hospitalo-universitaire de psychiatrie générale et de réhabilitation psychosociale 29G01 et 29G02, ER 7479 SPURBO, CHRU de Brest, hôpital de Bohars, Brest, France.
Background And Hypothesis: The development of paraclinical tools to assist clinical assessment is already widespread in nearly all other medical specialties. In psychiatry, many efforts are being made to improve management strategies using these new techniques. The first episode psychosis (FEP) is a clinical entity whose evolution after onset is difficult to predict in the current state of our practices.
View Article and Find Full Text PDFHCA Healthc J Med
December 2024
St George's University, Grenada, West Indies.
Background: The United States Food and Drug Administration approved 6 atypical antipsychotics for pediatric treatment of schizophrenia. However, little has been published on the effectiveness of these medications in the acute treatment setting of adolescents with psychosis. Since the clinical uncertainty and poor prognosis proceeding the early onset of schizophrenia has a significant impact on a child's development, there is a critical need for evidence-based data on this population.
View Article and Find Full Text PDFJ Child Psychol Psychiatry
January 2025
Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Psychosis in children and adolescents has been studied on a spectrum from (common) psychotic experiences to (rare) early-onset schizophrenia spectrum disorders. This research review looks at the state-of-the-art for research across the psychosis spectrum, from evidence on psychotic experiences in community and clinical samples of children and adolescents to findings from psychosis risk syndrome research, to evidence on early-onset psychotic disorders. The review also looks at new opportunities to capture psychosis risk in childhood and adolescence, including opportunities for early intervention, identifies important unanswered questions, and points to future directions for prevention research.
View Article and Find Full Text PDFPsychopharmacol Bull
January 2025
Abhishek Reddy, MD, Assistant Professor, Child and Adolescent Psychiatry, Sleep Medicine, Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States.
Eur Neuropsychopharmacol
December 2024
Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Older Adults with Bipolar Disorder (OABD) represent a heterogeneous group, including those with early and late onset of the disorder. Recent evidence shows both groups have distinct clinical, cognitive, and medical features, tied to different neurobiological profiles. This study explored the link between polygenic risk scores (PRS) for bipolar disorder (PRS-BD), schizophrenia (PRS-SCZ), and major depressive disorder (PRS-MDD) with age of onset in OABD.
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