Does your child say he/she hears, sees or smells things that aren't there?
- What is psychosis?
- Psychosis is a condition in which children and adolescents experience hallucinations or delusions, as well as other bizarre behaviors. These symptoms and/or behaviors may or may not interfere with their overall social or school performance or abilities.1
- Hallucinations are defined as sensing things that are not actually there (i.e., that others cannot sense). These may be related to hearing, seeing, smelling, tasting, or feeling things (although hearing things is the most common type).
- Delusions are defined as strange and incorrect beliefs that involve a lack of understanding or poor interpretation of experiences or awareness. These may involve (but are not limited to) thoughts that others are out to hurt one’s self, beliefs that others are attempting to trick or ridicule one’s self, and/or beliefs that gestures or passages from books or songs are directed at one’s self.
- There are several disorders that are considered psychotic disorders, in which psychosis is a major feature of the disorder. These include (but are not limited to): Schizophrenia, Schizophreniform Disorder, Schizoaffective Disorder, Delusional Disorder, and Brief Psychotic Disorder.
- Schizoprenia occurs when a child or adolescent experiences at least 2 of the following symptoms for at least 6 months: hallucinations, delusions, disorganized speech (i.e., often getting off-track from one topic to another, answering questions with unrelated and unimportant information), very disorganized behavior (i.e., very irritable and/or overly silly behavior), limited motor behavior (i.e., not responding to the environment, rigid posture with difficulty moving and/or resistant to move), obvious lack of emotional response, abnormal lack of speech, and/or showing little interest in participating in activities (i.e., school, play, social activities). These symptoms must interfere with the child or adolescent’s social or school activities, particularly when compared to the child or adolescent’s abilities to participate and succeed in these activities prior to the development of psychosis.
- Schizophreniform Disorder shares many symptoms of Schizophrenia. However, in Schizophreniform Disorder, symptoms in the child or adolescent does not need to cause impairment in their social or school abilities. Additionally, symptoms in Schizophreniform Disorder must last at least 1 month but less than 6 months.
- Schizoaffective Disorder shares many symptoms with Schizoprenia as described above, but these symptoms must also be accompanied by symptoms of a mood disorder (e.g., seem very sad and/or irritable most of the day almost every day, show little interest in activities they used to enjoy, fail to make expected weight gains, have poor sleep habits; be overly confident about their abilities, have a lot of energy without getting much sleep, be very talkative and/or have racing thoughts, become much more active than usual, and/or take part in dangerous activities).
- Delusional Disorder occurs when a child or adolescent experiences delusions for at least 1 month, but does not qualify for a diagnosis of Schizophrenia. Additionally, children and adolescents diagnosed with Delusional Disorder do not necessarily have impairment in their social or school activities.
- Brief Psychotic Disorder occurs when a child or adolescent has symptoms similar to Schizophrenia, including delusions, hallucinations, disorganized speech, or disorganized behavior, for at least 1 day but less than 1 month.
- How common is psychosis in children and adolescents?
- Schizophrenia is relatively rare in children, and is estimated to occur in approximately 1 in 40,000 children and adolescents worldwide (compared to 1 in 100 adults).2
- Slightly more boys are diagnosed with Schizophrenia than are girls.3
- Children diagnosed with Schizophrenia are more likely to have a relative diagnosed with psychosis or a personality disorder.3
- It is important to note that most children who report hallucinations do not qualify for a diagnosis of schizophrenia.4
- What can I do if my child has been diagnosed with psychosis?
- Visit a mental health professional who can assess your child for psychosis. Please click here to learn about mental health providers in your area who can assess for and/or treat psychosis in children. If you are outside the central MS area, please click on the following link(s) to learn about community mental health resources in your area: http://www.dmh.state.ms.us/pdf/CYSDirectory-Arial-9-15-08.pdf, http://www.nami.org/MSTemplate.cfm?Site=NAMI_Mississippi
- It is VERY important that a child who talks about hurting or killing themselves be evaluated by a mental health professional immediately. This type of assessment is important not only for diagnosis but also to keep the child safe.
- Occasionally psychosis-like symptoms may arise as a result of medications, medical conditions, or substance use. It is important that as part of any assessment of psychosis, a comprehensive medical history (including medication history) and history of substance use are taken to rule out possible other reasons for psychosis.1
- Additionally, some symptoms that may appear to be psychosis may be related to other mental health conditions, such as mood disorders or Pervasive Developmental Disorders (PDDs).1 It is therefore important that these disorders be ruled out in a comprehensive mental health evaluation before psychosis is diagnosed.
- The American Academy of Child and Adolescent Psychiatry (AACAP) is an organization that provides education for several audiences (including parents and families) addressing a wide range of mental health needs in children and adolescents. The website can be accessed at http://www.aacap.org/.
1American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed. rev.). Washington, D. C.: Author.
2Retrieved from http://www.schizophrenia.com/ami/diagnosis/kidbipol.html, March 2, 2009.
3Retrieved from http://www.schizophrenia.com/family/childonsetov.htm, March 2, 2009.
4Groisman et al., (2003). Children and adolescents who have schizophrenia. Pediatrics in Review, 24, 356-357.