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56 - Treatment of psychoses in children and adolescents

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Anthony James  and
Jon McClellan
Edited by
Peter Tyrer  and
Kenneth R. Silk
Anthony James
Affiliation:
High Adolescent and Family Unit Warneford Hospital Oxford UK
Jon McClellan
Affiliation:
Department of Child and Adolescent Psychiatry University of Washington Seattle, WA USA
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

This section discusses treatment of psychoses in children and adolescents. The psychoses here are caused by schizophrenia or bipolar disorders, and the treatment of other psychoses that occur in youth, such as in developmental disorders, is discussed elsewhere. The most effective treatments for psychoses appear to be with the antipsychotic medications, and the atypical antipsychotics are used here. The chapter on child and adolescent psychopharmacology covers in much more detail the issues that need to be considered when prescribing psychotropic medication to children. Overall, children and adolescents may be more sensitive to the extrapyramidal and the weight gain side effects when compared to their adult counterparts, and this is so even when the choice of antipsychotic medication is an atypical. Atypicals appear effective in both schizophrenia and bipolar disorder, and in bipolar disorder appear to work better when combined with mood stabilisers. Evidence for family therapy and cognitive-behavioural therapy is scant, and even the scant evidence does not provide a solid basis for effectiveness of these interventions in families or patients with either bipolar disorder or schizophrenia. ECT may be used in the most severe of the patients in this population, but ECT is much more effective in mood disorders, especially depression, than in schizophrenia or other psychotic states or disorders.

Introduction

There is a lack of researched-based evidence, particularly randomized controlled trials (RCTs), to guide the clinician in making decisions on the treatment of psychosis in children and adolescents.

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 819 - 829
Publisher: Cambridge University Press
Print publication year: 2008

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  • Treatment of psychoses in children and adolescents
    • By Anthony James, High Adolescent and Family Unit Warneford Hospital Oxford UK, Jon McClellan, Department of Child and Adolescent Psychiatry University of Washington Seattle, WA USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.058
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  • Treatment of psychoses in children and adolescents
    • By Anthony James, High Adolescent and Family Unit Warneford Hospital Oxford UK, Jon McClellan, Department of Child and Adolescent Psychiatry University of Washington Seattle, WA USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.058
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  • Treatment of psychoses in children and adolescents
    • By Anthony James, High Adolescent and Family Unit Warneford Hospital Oxford UK, Jon McClellan, Department of Child and Adolescent Psychiatry University of Washington Seattle, WA USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.058
Available formats
×