Child and Adolescent Psychosis

This article summarizes phenomenology, evaluation, and treatment of early-onset psychosis (beginning prior to age 18), childhood-onset psychosis (beginning prior to age 13), and psychosis risk syndromes. It is important to identify primary psychotic disorders like schizophrenia early to optimize prognosis, but over-diagnosis should be avoided since antipsychotic medications used to treat these disorders have many potential side effects. Especially in pre-adolescent children, who very rarely develop primary psychotic disorders, it is important to consider the possibility of nonpathological experiences (such as imaginary friends and hypnogogic hallucinations), delirium, autoimmune encephalopathies, genetic syndromes, and other specific medical causes of psychotic-like symptoms.