La psicosi e i disturbi psicotici nei bambini e negli adolescenti

Abstract

Psychosis can present a variety of symptoms such as hallucinations, delusions, catatonia, thought and speech disorganization, alogia, avolition and general functional decline. Transient psychotic symptoms are not uncommon during development and are not always indicative of psychopathology. Psychosis can be a manifestation of a schizophrenia spectrum disorder, or occur in the context of a mood disorder, such as major depression or bipolar mania. It can also be due to substance abuse or certain medical conditions, such as the NMDA encephalitis. Most cases of schizophrenia start between 15 and 25 years of age, while an onset under age 13 is rare. Schizophrenia tends to have an insidious onset with many months of subsyndromal and non-specific symptoms prior to the first openly psychotic episode. Repeated use of cannabis in youth increases the risk of psychosis, since the developing brain is especially sensitive to the psychoactive effects of tetrahydrocannabinol. As the duration of untreated psychosis predicts worse functional outcomes over time, a prompt recognition and early treatment of psychotic disorders has high clinical relevance. To this end, a close collaboration between paediatricians and child and adolescent neuropsychiatrists is crucial.