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2 results

  • Chapter 14 - Psychosis in Children and Adolescents

  • Edited by Shermin Imran, Greater Manchester NHS Foundation Trust
  • Book:
    Seminars in Child and Adolescent Psychiatry
    Print publication:
    30 October 2025, pp 219-230

  • Summary

    Early-onset psychosis (EOP) is a severe mental disorder with a significant impact on affected children, young people and their families. Its assessment and diagnosis may be challenging, treatment approaches may not always lead to full remission of symptoms, and it is frequently associated with recurrent episodes and long-term disability. A comprehensive evaluation of psychotic symptoms, co-morbidities, physical health and environmental risk factors is likely to contribute to the holistic understanding of the child or adolescent with psychosis and provide the best possible management framework. A systematic approach to treatment with antipsychotic medication and psychosocial interventions should incorporate regular reviews of its effectiveness and adverse effects. Early intervention seems to lead to optimal outcomes through reducing the duration of untreated psychosis and providing input during the critical period after its onset when treatment can be most effective. Further research aiming to advance our understanding of the complex aetiology of psychotic disorders, effectiveness of management strategies, and necessary service provision is urgently needed.

  • Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis

  • Gonzalo Salazar de Pablo, Ana Catalan, Julio Vaquerizo Serrano, Borja Pedruzo, Luis Alameda, Veronica Sandroni, Alvaro Armendariz, Victoria Rodriguez, Celso Arango, Carmen Moreno, Johnny Downs, Chris Abbott, Jae Il Shin, Marco Solmi, Paolo Fusar-Poli, Christoph U. Correll
  • Journal:
    The British Journal of Psychiatry / Volume 223 / Issue 1 / July 2023
    Published online by Cambridge University Press:
    17 May 2023, pp. 282-294
    Print publication:
    July 2023
    • Article
      • You have access
      • Open access
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  • Background

    Early-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited.

    Aims

    To provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P.

    Method

    PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle–Ottawa Scale.

    Results

    Of 3289 articles, 133 were included (n = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; n = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%–75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3–92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication.

    Conclusions

    Negative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available.