Children With Schizophrenia: Diagnosis, Phenomenology, and Pharmacotherapy

Spencer, Elizabeth K.; Campbell, Magda

doi:10.1093/schbul/20.4.713

“…The BPRS-C is a 21-item, clinicianrated, 0-6 scale assessing psychiatric symptoms frequently seen in children receiving psychiatric treatment. The total score has been shown to be sensitive to treatment effects in both depressive illness and schizophrenia (Spencer and Campbell, 1994;Emslie et al, 1997;Hughes et al, 2001). Further, the total score more comprehensively assesses the range of behavioral problems observed in youth with psychosis than the thinking disturbance and withdrawal subscales do (McClellan et al, 2002).…”

Section: Evaluation Of Efficacymentioning

confidence: 99%

“…Due to concerns about withholding treatment in psychotic youth, haloperidol was used as the comparator rather than placebo. We felt this was justified because there have been two placebo-controlled studies establishing haloperidol's efficacy in schizophrenic youth (Pool et al, 1976;Spencer and Campbell, 1994).…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Risperidone, Olanzapine, and Haloperidol in Psychotic Youth: A Double-Blind, Randomized, 8-Week Trial

Sikich

¹

,

Hamer

²

,

Bashford

³

et al. 2003

Neuropsychopharmacol

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This pilot study was undertaken to estimate the acute antipsychotic effect size and side effect propensity of risperidone and olanzapine in the pediatric population, in comparison to haloperidol, a conventional antipsychotic with established efficacy. Risperidone and olanzapine are widely used as first-line treatments to ameliorate psychotic symptoms in youth, but their abilities to specifically treat children and adolescents presenting due to psychotic symptoms have not been rigorously studied. Subjects, selected because of prominent positive psychotic symptoms, were randomly assigned to double-blind, parallel treatment with risperidone, olanzapine, or haloperidol for 8 weeks. The primary outcome was reduction in the Brief Psychiatric Rating Scale for Children total score from baseline to termination. An exploratory, descriptive analysis was done to compare the three treatments. A total of 50 patients, 8-19 years, participated. All treatments reduced symptoms significantly with p-values (corrected for multiple comparisons) of 0.0018 for each of the atypical agents and 0.012 for haloperidol. In all, 88% of subjects treated with olanzapine, 74% treated with risperidone, and 53% treated with haloperidol met response criteria. The primary side effects observed in all patients were mild to moderate sedation, extrapyramidal symptoms, and weight gain. Risperidone and olanzapine acutely reduced psychotic symptoms in this pediatric sample. Exploratory comparisons indicate the magnitude of the antipsychotic response with these atypical agents is comparable to that observed with haloperidol. However, youth treated with risperidone and olanzapine experienced weight gain and extrapyramidal effects that appear more prevalent and severe than reported in adults.

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“…Estudos da última década têm indicado que os crité-rios para o diagnóstico de esquizofrenia em crianças podem ser os mesmos utilizados em adultos [67][68][69] . Assim, as manifestações iniciais de esquizofrenia na criança e no adolescente são semelhantes àquelas observadas nos adultos.…”

Section: Esquizofreniaunclassified

Early manifestations of behavioral disorders in children and adolescents

Grillo

¹

,

Silva

²

2004

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Objective: To discuss the early diagnosis of behavioral disorders in childhood and adolescence and to provide the pediatrician with practical knowledge about the first symptoms of the main behavioral disorders at this age. Sources of data: PubMed (emphasis on the past decade).Summary of the findings: Pediatricians should be prepared to detect behavioral disorders as early as possible. Early detection could improve outcome and/or lead to etiologic diagnosis of mendelian inheritance disorders, allowing genetic counseling. Early symptoms of pervasive developmental disorders, attention deficit/hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, depression, schizophrenia, the main eating disorders (anorexia nervosa and bulimia nervosa) and substance use and abuse are discussed. Conclusions:The early symptoms of the main behavioral disorders in children and adolescents may appear before the age in which these conditions are currently diagnosed. Detection of early symptoms leads to early intervention, proper orientation about prognosis and, in some cases, to genetic counseling. The comorbidity among these disorders is frequent, and the symptoms of one disorder could be the first clue to allow the diagnosis of other conditions. J Pediatr (Rio J). 2004;80(2 Supl):S21-S27: Behavioral disorder, early diagnosis, child, adolescent. ResumoObjetivo: Revisão sobre o diagnóstico precoce dos principais transtornos do comportamento na criança e no adolescente, fornecendo informações práticas relativas às primeiras manifestações clínicas e à importância do diagnóstico precoce. Fontes dos dados:Revisão narrativa, com levantamento na PubMed das publicações que contêm aspectos do diagnóstico precoce, especialmente na última década. Síntese dos dados:Os pediatras devem estar preparados e atentos para detectar precocemente um transtorno do comportamento, já que, em alguns desses transtornos, intervenções precoces podem melhorar a evolução. Além disso, essas intervenções podem levar ao diagnóstico de doenças de herança mendeliana, passíveis de aconselhamento genético. São enfocadas as manifestações precoces dos transtornos invasivos do desenvolvimento, do transtorno do déficit de atenção/hiperatividade, do transtorno de ansiedade de separação, do transtorno de ansiedade generalizada, da depressão, da esquizofrenia, dos principais transtornos alimentares da criança maior ou adolescente (anorexia nervosa e bulimia nervosa) e do uso e abuso de substâncias. Conclusões:As manifestações precoces dos principais transtornos do comportamento na criança e no adolescente podem ser observadas antes da idade na qual o diagnóstico tem sido habitualmente estabelecido. O diagnóstico precoce implica intervenções precoces e orientação dos pais a respeito do prognóstico ou, em algumas situações, aconselhamento genético. A comorbidade entre esses transtornos é muito freqüente, e a manifestação de uma delas pode ser a pista para o diagnóstico de outra. IntroduçãoNão há consenso sobre uma definição dos transtornos do co...

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“…[67][68][69] Thus, the initial symptoms of schizophrenia in children and adolescents are similar to those observed in adults. There may be delusions, hallucinations, disorganized speech and behavioral disorders, or the so-called negative symptoms, such as blunting of affect.…”

Section: Schizophreniamentioning

confidence: 72%

Manifestações precoces dos transtornos do comportamento na criança e no adolescente

Grillo¹,

Silva²

2004

J. Pediatr. (Rio J.)

13

0

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Objective: To discuss the early diagnosis of behavioral disorders in childhood and adolescence and to provide the pediatrician with practical knowledge about the first symptoms of the main behavioral disorders at this age.Sources of data: PubMed (emphasis on the past decade).Summary of the findings: Pediatricians should be prepared to detect behavioral disorders as early as possible. Early detection could improve outcome and/or lead to etiologic diagnosis of mendelian inheritance disorders, allowing genetic counseling. Early symptoms of pervasive developmental disorders, attention deficit/hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, depression, schizophrenia, the main eating disorders (anorexia nervosa and bulimia nervosa) and substance use and abuse are discussed. Conclusions:The early symptoms of the main behavioral disorders in children and adolescents may appear before the age in which these conditions are currently diagnosed. Detection of early symptoms leads to early intervention, proper orientation about prognosis and, in some cases, to genetic counseling. The comorbidity among these disorders is frequent, and the symptoms of one disorder could be the first clue to allow the diagnosis of other conditions.

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Children With Schizophrenia: Diagnosis, Phenomenology, and Pharmacotherapy

Cited by 108 publications

References 36 publications

A Pilot Study of Risperidone, Olanzapine, and Haloperidol in Psychotic Youth: A Double-Blind, Randomized, 8-Week Trial

A Pilot Study of Risperidone, Olanzapine, and Haloperidol in Psychotic Youth: A Double-Blind, Randomized, 8-Week Trial

Early manifestations of behavioral disorders in children and adolescents

Manifestações precoces dos transtornos do comportamento na criança e no adolescente

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