Abstract:
OBJECTIVE:Psychotic disorders in childhood and early adolescence often progress to chronic schizophrenia, but in many cases there are diagnosable medical and genetic causes or risk factors. We reviewed our clinical experience and the relevant literature to identify these factors and to define their clinical features, appropriate work-up and treatment. METHOD:We reviewed the results of comprehensive medical evaluations of 160 psychotic children and adolescents in our center. We also searched the Medline database (January 1994 to December 2015) with the following keywords and combinations: early onset schizophrenia, childhood onset schizophrenia, early onset psychosis, first episode psychosis, inborn errors of metabolism (IEM), genetic syndrome, copy number variants, autoimmune disorders, endocrine diseases, nutritional deficiencies, central nervous system infections, movement disorders, and epilepsy. RESULTS:In our center, 12.5% of cases had medical disorders likely to be contributing to psychosis. Based on 66 relevant papers and our experience, we describe the clinical features of multiple genetic syndromes, IEM, and autoimmune, neurological, endocrinological and nutritional disorders that increase the risk of psychotic disorders in childhood and adolescence. We propose an algorithm for systematic laboratory evaluation, informed by clinical examination, emphasizing common and/or treatable factors. CONCLUSIONS:In children and early adolescents with psychotic disorders, systematic medical work-up is warranted to identify medical and genetic factors. Not every rare cause can be worked up, thus careful clinical examinations are required to detect medical, neurological and genetic signs. Comprehensive medical evaluation can detect treatable diseases among cases of early-onset psychosis.
journal_name
Schizophr Resjournal_title
Schizophrenia researchauthors
Giannitelli M,Consoli A,Raffin M,Jardri R,Levinson DF,Cohen D,Laurent-Levinson Cdoi
10.1016/j.schres.2017.05.011subject
Has Abstractpub_date
2018-02-01 00:00:00pages
39-49eissn
0920-9964issn
1573-2509pii
S0920-9964(17)30270-0journal_volume
192pub_type
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pub_type: 杂志文章
doi:10.1016/j.schres.2005.07.014
更新日期:2005-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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