Materiały źródłowe

• #1 Childhood schizophrenia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/diagnosis-treatment/drc-20354489

  Schizophrenia in children requires lifelong treatment, even during periods when symptoms seem to go away. Treatment is a particular challenge for children with schizophrenia. […] Childhood schizophrenia treatment is usually guided by a child psychiatrist experienced in treating schizophrenia. The team approach may be available in clinics with expertise in schizophrenia treatment. The team may include, for example, your psychiatrist, psychologist or other therapist, psychiatric nurse, social worker, family members, pharmacist, and case manager to coordinate care. […] The main treatments for childhood schizophrenia are medications, psychotherapy, life skills training, and hospitalization. […] Most of the antipsychotics used in children are the same as those used for adults with schizophrenia. Antipsychotic drugs are often effective at managing symptoms such as delusions and hallucinations.

• #1 Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6345123/

  TREATMENT OPTIONS FOR THE MANAGEMENT OF EARLY-ONSET SCHIZOPHRENIA […] Treatment options for the management of schizophrenia include antipsychotic medications, psychoeducation, psychosocial interventions, adjunctive medications, and electroconvulsive therapy (ECT). […] Antipsychotics […] Antipsychotic medications are considered as the first-line treatment for patients with EOS. However, these are recommended to be used along with psychosocial interventions. Compared to data in adults, the efficacy data on use of antipsychotic medications in children and adolescents are limited. Further, all the antipsychotics have not been evaluated in patients with EOS aged 18 years. Most of the antipsychotics have been evaluated in patients aged 13-18 years. The antipsychotics which have been evaluated in one or more randomized controlled trial (RCT) include haloperidol, aripiprazole, asenapine, paliperidone, risperidone, quetiapine, olanzapine, molindone, ziprasidone, and clozapine. Majority of the studies which have evaluated different antipsychotics in adolescent patients have been industry sponsored. One of the non-industry sponsored studies which have evaluated the efficacy of different antipsychotics in patients with schizophrenia/schizophrenia spectrum disorder includes Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) study. Many meta-analyses have evaluated the existing short-term (6-12-week trials) efficacy/effectiveness data with respect to use of antipsychotics in children and adolescents with schizophrenia. Some of the common conclusions of these meta-analyses include superior efficacy of antipsychotic medications when compared to placebo (except possibly for ziprasidone), lack of significant difference in efficacy between First generation Antipsychotic Medications (FGAMs) and Second Generation Antipsychotic Medications, and tolerability of SGAMs being better than FGAMs. Overall, antipsychotics have superior efficacy in terms of reduction in positive symptoms, and there is lack of significant beneficial effect on negative symptoms when compared to placebo. Data also suggest that there is no difference in efficacy between different SGAMs, except for the fact that clozapine is superior to other antipsychotics. SGAMs are associated with lower dropout rates compared to FGAMs. In terms of adverse effects, there is differential adverse effect profile of various antipsychotics, with extrapyramidal symptoms being more common in patients receiving FGAMs, hyperprolactinemia being more common with risperidone and FGAMs, and weight gain and metabolic side effects being more common with SGAMs, especially olanzapine. It is in general also suggested that side effect of antipsychotics in adolescents is similar to that seen in adult patient, except for the fact that adolescents experience more side effects.

• #1 Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6345123/

  Choice of antipsychotic medication in children and adolescents […] Based on the available evidence, antipsychotic medications are considered as the first-line treatment for schizophrenia in adolescents, which must be used along with the psychosocial management. Among the various antipsychotics, it is generally suggested that SGAMs, other than clozapine, may be used as the first-line agents. The United States Food and Drug Administration have approved haloperidol, molindone, risperidone, aripiprazole, quetiapine, paliperidone, and olanzapine for the management of schizophrenia among adolescents aged 13 years or more. It is suggested that selection of specific agent should be based on the side effect profile and various other factors. […] Monitoring of patients while receiving antipsychotics for side effects

• #1 Childhood-Onset Schizophrenia Medication: First Generation Antipsychotics (Typical), Second Generation Antipsychotics (Atypical), Benzodiazepines, Antiparkinsonian Agents, Antihistamines, Beta-adrenergic Blockers, Dopamine Agonist

  https://emedicine.medscape.com/article/914840-medication

  Paliperidone is indicated in adults for the acute and maintenance treatment of schizophrenia. It is also approved by the FDA to treat schizophrenia in adolescents. […] Patients treated with olanzapine had higher BMI compared to patients treated with other antipsychotics at six months, but no longer significantly higher at twelve and twenty-four months. […] Patients treated with risperidone had worse neurological side effects compared to other antipsychotics at six months, but no longer statistically significantly worse at twelve and twenty-four months. […] Clozapine has been demonstrated to be: (1) effective for childhood-onset schizophrenia in double-blind studies as well as (2) superior to haloperidol in treatment of children with schizophrenia. However, this agent remains second-line because of its major adverse effects.

• #1 Childhood-Onset Schizophrenia Medication: First Generation Antipsychotics (Typical), Second Generation Antipsychotics (Atypical), Benzodiazepines, Antiparkinsonian Agents, Antihistamines, Beta-adrenergic Blockers, Dopamine Agonist

  https://emedicine.medscape.com/article/914840-medication

  Despite these risks and concerns, clozapine is generally safe and effective in the treatment of refractory early onset schizophrenia. […] A systematic review and Network Meta-Analysis, ziprasidone was found to have limited or no effect on decreasing total and positive symptoms in the treatment of schizophrenia in patients less than nineteen years old. […] In the treatment of early-onset schizophrenia spectrum disorders (TEOSS) study, the efficacy of olanzapine and risperidone was compared with molindone (a first-generation antipsychotic medication) in the treatment of early-onset schizophrenia and schizoaffective disorder in a double-blind multisite trial. […] Weight gain has been a problem with all currently available atypical antipsychotics, although weight gain may be less of a problem with ziprasidone. Pediatric patients with childhood-onset schizophrenia are already at higher risk for obesity and metabolic syndrome. Prescribing second-generation antipsychotics may put these patients at even greater risk for weight-gain and development of metabolic syndrome. Its suggested clinicians consider the addition of metformin when initiating pediatric patients on second-generation antipsychotics. This is not yet standard of care, but could be considered based on clinical circumstances.

• #1 Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6345123/

  All the patients receiving antipsychotics should be monitored throughout the treatment for EPS, i.e., drug-induced parkinsonism, dystonia, akathisia, and neuroleptic malignant syndrome. Patients should also be monitored for other side effects. EPS is more often seen in patients receiving FGAMs, especially high-potency antipsychotics such as haloperidol. EPS is also known to occur with SGAMs. Acute EPS is usually seen during the first few days or weeks of starting treatment and can manifest in the form of acute dystonia, pseudo-parkinsonism, and akathisia. Acute EPS is usually dose dependent and subsides with discontinuation of the offending agent. Unlike acute EPS, chronic EPS is not dose dependent and usually encountered with prolonged use (months to years) of antipsychotics and manifests in the form of tardive dyskinesia, tardive dystonia, and tardive akathisia. Chronic EPS often persists even after discontinuation of the offending medication. Initial step in the management of parkinsonism involves reduction in the dose of the offending agent. If reduction in dose does not lead to resolution of symptoms or leads to inadequate control of symptoms or worsening of symptoms, then change to an antipsychotic medication with lower EPS potential needs to be considered.

• #1 Childhood-Onset Schizophrenia Treatment & Management: Approach Considerations, Medical Care, Psychosocial Management

  https://emedicine.medscape.com/article/914840-treatment

  Psychoeducational group interventions over 9 months focused on problem-solving strategies in the form of parallel parent and child groups led to significantly greater improvement in PANSS general scores and fewer emergency department visits compared to the non-structured interventions. […] Typical and atypical antipsychotic medications may stimulate the appetite. Low-calorie snacks and limitation of total intake at meals may help prevent excess weight gain. Weight and body mass index (BMI) should be monitored in all patients on atypical antipsychotics. […] Treatment before the emergence of psychosis is under investigation. […] This preliminary finding raises the possibility that children with prodromal symptoms of schizophrenia can be treated before the emergence of psychosis. Further study is required before such therapy can be recommended.

• #1 Childhood schizophrenia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/diagnosis-treatment/drc-20354489

  In addition to medication, psychotherapy, sometimes called talk therapy, can help manage symptoms and help you and your child cope with the disorder. Psychotherapy may include individual therapy and family therapy. […] Treatment plans that include building life skills can help your child function at age-appropriate levels when possible. Skills training may include social and academic skills training and vocational rehabilitation and supported employment. […] During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your child’s safety and make sure that he or she is getting proper nutrition, sleep, and hygiene. Sometimes the hospital setting is the safest and best way to get symptoms under control quickly.

• #1 Childhood schizophrenia: Diagnosis and treatment – Terapia Online Presencial Madrid | Mentes Abiertas

  https://www.mentesabiertaspsicologia.com/blog-psicologia/childhood-schizophrenia-diagnosis-and-treatment

  Treatment of childhood schizophrenia usually involves a combination of medications, therapy, and support psychosocial. […] Antipsychotics are medications that can help control the symptoms of schizophrenia in children. […] Cognitive therapy -behavioral can help children with schizophrenia identify and change negative or irrational thinking patterns, as well as develop effective coping skills to manage their symptoms and emotions. […] Support from the child’s family and social environment is essential in the treatment of childhood schizophrenia. […] Children with schizophrenia can benefit from educational programs specialized professionals that provide them with the support and resources necessary to face the challenges related to their illness. […] Detection Early and timely intervention in childhood schizophrenia can significantly improve the child’s long-term prognosis. […] With the right support, including medical treatment, therapy, and social support, children with schizophrenia can learn to manage their symptoms and live full, meaningful lives.

• #1 Childhood-Onset Schizophrenia Treatment & Management: Approach Considerations, Medical Care, Psychosocial Management

  https://emedicine.medscape.com/article/914840-treatment

  A case series in France suggested transcranial magnetic stimulation (TMS) may be therapeutic in the treatment of early-onset refractory auditory hallucinations in patients with childhood-onset schizophrenia. The patients in this study found benefit lasting one month after treatment. […] The child with schizophrenia requires multimodal care. This should include social skills training, a supportive environment, and a structured individualized special education program. […] Supportive psychotherapy is used to encourage reality testing and to help the child monitor for warning symptoms of impending relapse. […] Cognitive behavioral therapy has been used successfully in adults with schizophrenia and may help improve coping with schizophrenia and monitoring of beliefs and attributions. […] Cognitive remediation therapy in addition to treatment-as-usual in patients with early-onset schizophrenia was found to significantly improve verbal memory, executive function, daily living and adaptive functioning, and improvements in family burden.

• #1 The Realities of Childhood Schizophrenia

  https://www.psychiatrictimes.com/view/realities-childhood-schizophrenia

  For children with schizophrenia who experience persistent cognitive decline such as difficulty concentrating or remembering, cognitive remediation is recommended along with antipsychotic medications. […] I strongly recommended a multimodal instead of medication-alone approach for a better outcome. […] For patients with schizophrenia who have had a recent psychotic episode and have significant ongoing contact with family members, we recommend patients and family members receive a family intervention for at least 6 to 9 months. […] For individuals who experience persistent delusions or hallucinations despite adequate trials of antipsychotic medication, we recommend adjunctive treatment with cognitive-behavioral therapy over medication alone. […] Social skills training is necessary since negative symptoms of schizophrenia such as lack of motivation and lack of socialization do not respond well to medications. […] The aim is to reduce the intensity of delusions and hallucinations or the subjective distress.

• #1 Cognitive Behavioral Therapy for Schizophrenia | NYU Langone Health

  https://nyulangone.org/conditions/schizophrenia/treatments/cognitive-behavioral-therapy-for-schizophrenia

  Cognitive behavioral therapy, also known as CBT, may be a treatment option for people with schizophrenia. […] Cognitive behavioral therapy is a short-term, problem-focused approach with the goal of teaching people who have schizophrenia a variety of coping skills to help them manage difficult situations. […] Cognitive behavioral therapy can also help people with schizophrenia to develop better social and problem-solving skills, reduce the severity of symptoms, and lower the risk of relapse, a period of time when schizophrenia symptoms return.

• #1 Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6345123/

  Family interventions […] Family interventions, mainly in the psychoeducational format, can be useful in patients with schizophrenia. These interventions can be provided in the informal or unstructured form, structured format, individual or group format, and as specific strategy or as integrated psychosocial treatments combined with components of other psychosocial treatments. The basic emphasis of the family intervention programs should be on regular treatment contact with emphasis on the need for regular medication adherence and providing emotional and practical support. Family-based interventions also focus on communication patterns to address the issue of expressed emotions. The family intervention programs should be designed in such a way these meet the need of the patients and the family.

• #1 Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6345123/

  Psychoeducation […] Psychoeducation of both patient and family members is an integral part of management of schizophrenia. The basic component of psychoeducation includes providing information about the disorder and the available treatment options to the patient and the family. Effort must be made to provide simple and brief explanation about the nature of the illness, available treatments, possible side effects which may be encountered, and duration of treatment. Use of technical jargon should be kept to minimum and clinical information need to be provided in the language in which patient and the parents/caregivers are most comfortable. Further, there should be no information overload for the participants, rather information needs to be passed on in piece-meal fashion, tailored according to the acceptability of the patient and the family members. During psychoeducation, patient and family must be given enough opportunity to ask questions and clarify their doubts and misconceptions about the illness. Diagnosis of schizophrenia in children is often traumatic for the parents and to the sufferer too; hence, enough time must be given to the parents and the patient to accept this painful fact. Many a times, parents blame themselves or their partner for the illness in the child. Efforts must be made that no blame is attached to any one member of the family. An important aspect of psychoeducation is also to emphasize the need for regular intake of medication.

• #1 Alternative Treatment for Schizophrenia without Medication – Non-Pharmacological Interventions for Schizophrenia | Lighthouse Network

  https://lighthousenetwork.org/resources/how-to-identify-and-treat-childhood-schizophrenia/

  These interventions work hand-in-hand with antipsychotics in the treatment of childhood schizophrenia. […] Tailored to fit the needs of the patients and their families while promoting frequent therapeutic contact, the need for medication adherence, and delivering emotional and practical support […] Aims to improve understanding of illness, alleviate the distress associated with hallucinations, and minimizes the degree of preoccupation with delusional beliefs. […] It has been proven to increase planning capacity and cognitive flexibility in childhood schizophrenia. […] Supportive therapy for childhood schizophrenia is the act of creating a therapeutic alliance with the child’s patients. […] Of course, the choice of treatment will be tailored according to how the child presents and responds to the treatment course of childhood schizophrenia.

• #1 Childhood-Onset Schizophrenia Treatment & Management: Approach Considerations, Medical Care, Psychosocial Management

  https://emedicine.medscape.com/article/914840-treatment

  Acute inpatient care is necessary for persons with behaviors dangerous to self or others. The child with schizophrenia who is severely impaired may need day treatment programs or hospitalization until the child is stabilized and not considered a danger to self or others. […] Pharmacotherapy is essential in the treatment of individuals with childhood-onset psychosis. Electroconvulsive therapy (ECT) has also been used adjunctively in rare cases. […] The first-line agents are neuroleptics. Newer atypical antipsychotic agents are generally chosen as the initial medications of choice. […] Many second-generation antipsychotics have been approved by the FDA in recent years for adolescents to treat schizophrenia including aripiprazole, lurasidone, olanzapine, quetiapine, paliperidone, and risperidone.

• #1 Childhood Schizophrenia: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21067-childhood-schizophrenia

  Treatment for very early-onset schizophrenia depends on your child and the type and severity of their symptoms. Treatment usually includes therapy and education for both the child and their family. Depending on your child’s age, their provider may prescribe antipsychotic medications and sometimes, antidepressants to help control symptoms. At some point, many children with schizophrenia require hospitalization for their safety. They may also need to stay in the hospital from time to time if they’re unstable or as they start new medications. […] In addition to medications, providers often recommend social skills training and counseling for the child and their family. Ongoing individual therapy helps children with schizophrenia learn coping skills. This support can help them maintain relationships and do better in school.

• #1 Schizophrenia in Kids: A Quick Guide

  https://childmind.org/guide/quick-guide-to-schizophrenia/

  Schizophrenia is usually treated with therapy and medication. […] The recommended treatment is a special program called Coordinated Specialty Care. This should be done in the first two or three years after the child shows signs of schizophrenia. It can decrease symptoms in the future by a lot and help with many of the problems linked to this illness. […] Coordinated Specialty Care teaches kids how to deal with their symptoms. It also helps them build a group of people who can help them. The treatment includes: Low doses of antipsychotic medication, Cognitive behavioral therapy for psychosis (CBTp), Family education and support, Learning skills for school and work.

• #1 First Psychotic Episode: Why Early Treatment Is Critical – Child Mind Institute

  https://childmind.org/article/first-episode-psychosis-early-treatment-critical/

  The right care for teenagers and young adults after a first psychotic episode decreases later relapses by more than 50% […] The good news is that getting a treatment called Coordinated Specialty Care, or CSC, right after a first episode cuts the chances of later ones in half. […] The goal of CSC is to help a person learn to manage their symptoms and build a support network. […] The treatment that has been shown to be successful, called Coordinated Specialty Care, involves a combination of services coordinated by a group of professionals working with the patient and the family. […] Unlike the old standard treatment for schizophrenia, which involved higher doses of medication and no follow-up after hospitalization, the goal of early treatment is not only to reduce psychotic symptoms, but also to help young people learn to manage them and to construct a support network to prevent relapse.

• #1 Treatment of Early Onset Schizophrenia: Recent Trends, Challenges and Future Considerations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3317175/

  Hence, there is a dire need for early characterization of symptoms and biomarkers, better understanding of the pathophysiology and progression of the illness, and exploring novel and outside the box treatment options such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) trials, which are well tolerated in pediatric populations.

• #1

  https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Schizophrenia-In-Children-049.aspx

  Schizophrenia is a serious psychiatric illness that causes changes in thinking, feelings, and unusual or strange behavior. […] Early diagnosis and medical treatment are important. Schizophrenia is a life-long disease that can be controlled but not cured. […] Parents should ask their family physician or pediatrician to refer them to a child and adolescent psychiatrist, who is specifically trained and skilled at evaluating, diagnosing, and treating children with schizophrenia. Treating children with schizophrenia can involve a combination of medication, individual therapy, and family therapy, and specialized programs (school, activities, etc.) are often necessary. Psychiatric medication can be helpful for many of the symptoms of the illness. These medications require careful monitoring by a psychiatrist (preferably a child and adolescent psychiatrist).

• #1 Pediatric Schizophrenia – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/schizophrenia

  Individual and family therapy. This may include supportive, thinking and behavioral therapy. […] Self-help and support groups. These can help the child learn ways to cope with the disorder and also work on social skills. […] Experts don’t know how to prevent schizophrenia. But early diagnosis and treatment can improve a child’s quality of life. Treatment works best when early symptoms are dealt with quickly. […] Schizophrenia is a serious mental illness that will require your support, patience and attention. You are your child’s best advocate. Here are things you can do to help: […] Talk with your child’s healthcare provider about referring your child to a psychiatrist with experience evaluating and treating children with schizophrenia. […] Take all symptoms of depression and suicide very seriously. Seek treatment right away. Suicide is a health emergency. Call 911 if your child has suicidal thoughts, a suicide plan and the means to carry out the plan.

• #1 Schizophrenia | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/s/schizophrenia

  Individual and family psychotherapy. Individual therapy may focus on developing social skills. Family therapy may help family members cope with the child’s illness. […] Specialized educational or structured activity programs social skills training, vocational training, speech and language therapy, smaller classroom size, modification of academic work. […] Treatment is most successful when symptoms of the first psychotic episode are addressed quickly and properly. Studies suggest that early treatment may keep the illness from getting worse and help reduce some of the long-term effects of schizophrenia. […] It is important to the success of the treated child or teen who is prescribed medicines for the treatment of schizophrenia to keep taking the medicine as prescribed. Dosages and types of medicines may need to be adjusted from time to time to stay effective. Always consult your child’s physician for more information.

• #1

  https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Schizophrenia.aspx

  There are other treatments that can improve your childs life too. For instance, family therapy can boost your familys communication and help you learn more about what your child is dealing with. […] Early intervention can greatly improve symptoms for a child or teen with schizophrenia. Left untreated, schizophrenia can cause serious behavioral, emotional, and health problems. If you think your child has signs or symptoms of schizophrenia, be sure to talk to your pediatrician.

• #1 First Psychotic Episode: Why Early Treatment Is Critical – Child Mind Institute

  https://childmind.org/article/first-episode-psychosis-early-treatment-critical/

  The earlier we intervene, the better the outcome […] Patients also vary in their receptiveness to therapy and taking medication. An important part of the program is empowering the individuals who are being treated to participate with the professionals in joint decision-making about their treatment. […] Part of the goal of early treatment is to eliminate the stigma attached to schizophrenia, and to show patients, and their families, that it is a more manageable illness than they may think.

• #1 Pediatric Schizophrenia – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/schizophrenia

  Schizophrenia is a serious mental illness. Treatment is complex and needs direction from an expert in childhood schizophrenia. […] Children often need a combination of therapies and resources to meet their specific needs. Treatment may include: […] Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is. […] Schizophrenia is a serious, life-long mental illness. Treatment is complex and needs direction from an expert in childhood schizophrenia, such as a board certified child psychiatrist. A child often needs a combination of therapies and resources to meet the specific needs. Treatment is aimed at easing symptoms and improving your child’s quality of life. It may include the following. […] Medicines to help reduce delusions and hallucinations (antipsychotics). This special class of medicines can reduce symptoms or reduce how severe the symptoms are. But they don’t cure schizophrenia.

• #1 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02581

  Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. […] Schizophrenia is a serious, lifelong mental illness. Treatment is complex and needs direction from an expert in childhood schizophrenia, such as a board-certified child psychiatrist. A child often needs a combination of therapies and resources to meet their specific needs. Treatment is aimed at easing symptoms and improving your child’s quality of life. It may include the following. […] Medicines to help reduce delusions and hallucinations (antipsychotics). This special class of medicines can reduce symptoms or reduce how severe the symptoms are. But they dont cure schizophrenia. […] Individual and family therapy. This may include supportive, thinking, and behavioral therapy.

• #1

  https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Schizophrenia.aspx

  If your child is diagnosed with schizophrenia, theyll need treatment for the rest of their life. A child psychiatrist with experience in treating kids with schizophrenia will likely be in charge of your childs care. There will probably be other team members too, such as nurses and therapists. […] Treatments for schizophrenia include: […] Antipsychotic medications are the foundation of treatment for kids and teens with schizophrenia. These medicines are the same kinds that are used for adults with schizophrenia. They help with psychotic symptoms like hallucinations and delusions. […] Psychotherapy, also known as talk therapy, is another instrumental part of your childs treatment. One type thats good for treating schizophrenia is cognitive behavioral therapy (CBT). It can help your child cope with hallucinations and delusions, as well as work on behaviors. It also helps them learn to manage the challenges and stress that schizophrenia can create.

• #1 Schizophrenia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/schizophrenia

  While schizophrenia is a chronic disorder that requires lifelong management, there is hope. With proper treatment, many children with schizophrenia are able to go to college, hold jobs and have families as adults. […] As one of the largest pediatric psychiatric services in New England, Boston Childrens has an experienced team of expert child psychologists, psychiatrists, neuropsychologists, social workers and other clinicians with extensive experience treating schizophrenia. We will work with you to design a treatment plan that not only meets the individual needs of your child, but also supports the emotional well-being of the entire family. […] We understand the many components involved in treating childhood schizophrenia, from medically managing the symptoms of the disease to educating family members and educators and locating resources in the community. Beginning with the initial diagnosis, your Boston Childrens team will explain the treatment options available to you and your child and help you identify the medications, educational and activity programs and family support systems you need.

• #1 Schizophrenia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/schizophrenia

  Treatment is most successful when symptoms are addressed early on. […] Your clinician will prescribe treatment methods that may include medication, psychotherapy, specialized educational or activity programs, and support groups. […] The use of medications (also called psychopharmacology) is essential in treating schizophrenia. The most commonly prescribed schizophrenia drugs are neuroleptics, or antipsychotic medications. These drugs act against the symptoms of schizophrenia, but cannot cure the disease itself. […] Psychotherapy also known as talk therapy is the cornerstone of psychiatric treatment at Boston Children’s. […] Treatment for schizophrenia will often include not only individual therapy for your child, but also family therapy for you and other loved ones, so that you have the information, support system, and other tools you need to become an active participant in your child’s care.

• #1 Schizophrenia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/schizophrenia

  Children and adolescents with schizophrenia may reap significant benefits from specialized programs offered at schools, in medical centers, or in the community. […] Schizophrenia support groups for children and families can be tremendously helpful. […] If schizophrenia is detected and treated early, and if medications and therapies are successful, the disease has an excellent treatment rate. […] The following factors are critical in successfully treating schizophrenia: building a foundation of family and school awareness and support, remaining under a clinicians care for therapeutic treatment and regular monitoring, seeking professional treatment as soon as symptoms emerge, taking prescribed medications exactly as directed and for as long as directed (often long-term or throughout the lifetime).

• #1 Recommendations | Psychosis and schizophrenia in children and young people: recognition and management | Guidance | NICE

  https://www.nice.org.uk/guidance/cg155/chapter/recommendations

  Health and social care providers should ensure that children and young people with psychosis or schizophrenia: are not passed from one team to another unnecessarily and do not undergo multiple assessments unnecessarily. […] Help the child or young person to continue their education. Contact the school or college, subject to consent, to ask for additional educational support if their performance has been affected by their condition. […] Provide access to peer support for children and young people with psychosis or schizophrenia, if support is available from children and young people of an appropriate developmental level, emotional maturity and cognitive capacity. […] When transient or attenuated psychotic symptoms or other mental state changes associated with distress, impairment or help-seeking behaviour are not sufficient for a diagnosis of psychosis or schizophrenia: consider individual cognitive behavioural therapy (CBT) with or without family intervention, and offer treatments recommended in NICE guidance for children and young people with any of the anxiety disorders, depression, emerging personality disorder or substance misuse.

• #1 Childhood Schizophrenia: Symptoms, Treatment, and Outlook

  https://www.webmd.com/schizophrenia/childhood-schizophrenia

  Schizophrenia treatment for children is like treatment for adults. It includes: […] Your doctor may suggest one or more antipsychotics. These drugs are also called neuroleptics. They manage delusions (beliefs in things that aren’t true) and hallucinations (seeing or hearing things that aren’t real). Talk with your doctor about side effects and other drugs your child shouldnt take while theyre using these medicines. […] Mental health professionals who specialize in childhood schizophrenia may help your child manage their symptoms. Family therapy and support groups can teach your child and others in the family about the disease and about how to deal with stressful situations. […] Special classes can teach your child social skills and how to do daily tasks. They can also get tips on how to overcome challenges in school. […] If your child has severe symptoms or a mental health crisis, a stay in the hospital can be the quickest way to get symptoms under control in a safe place. Other options include part-time hospital and home care.

• #1 Schizophrenia Treatment Center for Children & Teens in Arkansas | Millcreek Behavioral Health

  https://www.millcreekbehavioralhealth.com/mental-health/schizophrenia/

  Recreational therapy: All of the adolescents or teens in our schizophrenia treatment programs will participate in recreational therapy, which includes participating in activities such as creative arts, sports, social outings, park outings, adventure programs, and leisure. These activities are designed to aid in the development of appropriate social skills. […] […] Education: Every child and adolescent that we treat at Millcreek will attend our fully accredited school program, which is held Monday through Friday. Each child will be given a distinct, individualized education plan based on their specific academic needs. […] […] Once your child has completed our residential schizophrenia treatment program located in Arkansas, our facilitys case manager will meet with you and your child in order to help identify what the next best plan of action should be. These case managers can help schedule any necessary follow-up appointments with outpatient providers and can provide you and your child with specific resources that are available for support within your community. For those patients who qualify, there is the option of entering into a waiver program where individuals can return home and still receive any additional assistance with daily living skills that may be needed.

• #1 Childhood Schizophrenia: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21067-childhood-schizophrenia

  There isn’t a cure for schizophrenia. Even when they’re an adult, your child may experience symptoms of schizophrenia. They need continuous treatment to help them live a safe, productive life. […] Your child’s healthcare provider is the best person to tell you how long it will take for medication and therapy to work. Different medications take different amounts of time before they have noticeable effects. Their provider can also let you know about other treatment options that might help if the first treatments don’t work well.

• #1 Schizophrenia – Effective Child Therapy

  https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/schizophrenia/

  Childhood-onset schizophrenia is rare and represents a severe form of the disorder, with more pronounced early neurodevelopmental abnormalities and often a chronic, treatment-refractory course. It also poses unique challenges for diagnosis and treatment. […] Initiating treatment as early as possible may significantly improve a childs long-term outcome. There are few studies of treatment for child-onset schizophrenia. Because child-onset schizophrenia is often associated with significant developmental abnormalities, these youth are likely to require intensive services to assist with both mental health and daily functioning. […] Treatment guidelines for adolescents with psychotic symptoms recommend both medication and psychosocial interventions. There are early-treatment programs for psychotic disorders nationwide (e.g., see NAVIGATE program) that provide both medication and psychosocial interventions.

• #1 Schizophrenia in Kids: Symptoms, Diagnosis, and Treatment

  https://www.healthline.com/health/schizophrenia-in-kids

  Schizophrenia is a serious mental health condition that changes how you see reality. […] Here are some common treatment options: medications that treat psychosis, depression, anxiety, and other symptoms […] therapy for the child and the family […] cognitive behavioral therapy (CBT) to help with thinking skills and emotional symptoms […] social skills training to help your child understand and communicate with other people […] electroconvulsive therapy (ECT) when other treatments aren’t effective. […] Because EOS can affect social relationships, education, and many other outcomes, it’s important to work with healthcare professionals to find the right diagnosis and start a treatment plan as early as you can. […] Treatments can include medication, education for your family, and therapy to help young people build the skills they need to manage the condition. In rare cases, electroconvulsive therapy (ECT) may be an option. […] With ongoing support from family, healthcare professionals, educators, and career specialists, a young person with schizophrenia has a better chance of managing symptoms and living a healthier life.

• #2 Schizophrenia in Children

  http://healthlibrary.gradyhealth.org/Library/DiseasesConditions/Adult/Digestive/90,P02581

  Schizophrenia is a serious mental illness. It’s a long-lasting and disabling problem of the brain. It can be treated, but right now there is no cure. […] Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. […] Schizophrenia is a serious, lifelong mental illness. Treatment is complex and needs direction from an expert in childhood schizophrenia, such as a board-certified child psychiatrist. A child often needs a combination of therapies and resources to meet their specific needs. Treatment is aimed at easing symptoms and improving your child’s quality of life. It may include the following. […] Medicines to help reduce delusions and hallucinations (antipsychotics). This special class of medicines can reduce symptoms or reduce how severe the symptoms are. But they don’t cure schizophrenia.

• #2 Childhood schizophrenia | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/childhood-schizophrenia

  Childhood schizophrenia treatment is usually guided by a child psychiatrist experienced in treating schizophrenia. The team approach may be available in clinics with expertise in schizophrenia treatment. The team may include, for example, your: […] The main treatments for childhood schizophrenia are: […] Most of the antipsychotics used in children are the same as those used for adults with schizophrenia. Antipsychotic drugs are often effective at managing symptoms such as delusions and hallucinations. […] In addition to medication, psychotherapy, sometimes called talk therapy, can help manage symptoms and help you and your child cope with the disorder. Psychotherapy may include: […] Treatment plans that include building life skills can help your child function at age-appropriate levels when possible. Skills training may include: […] During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your child’s safety and make sure that he or she is getting proper nutrition, sleep and hygiene.

• #2 Childhood schizophrenia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483

  Childhood schizophrenia is essentially the same as schizophrenia in adults, but it starts early in life generally in the teenage years and has a profound impact on a child’s behavior and development. […] Schizophrenia is a chronic condition that requires lifelong treatment. Identifying and starting treatment for childhood schizophrenia as early as possible may significantly improve your child’s long-term outcome. […] Early identification and treatment may help get symptoms of childhood schizophrenia under control before serious complications develop. Early treatment is also crucial in helping limit psychotic episodes, which can be extremely frightening to a child and his or her parents. Ongoing treatment can help improve your child’s long-term outlook.

• #2 Current data and approaches related to treatment of childhood-onset schizophrenia

  https://psychiatry-psychopharmacology.com/en/current-data-and-approaches-related-to-treatment-of-childhood-onset-schizophrenia-131289

  Early onset schizophrenia is defined as the onset of psychosis before the age of 18 years and very early-onset schizophrenia is a term used for cases developing before the age of 13 years. […] The aim of this presentation is to review the recent studies related to treatment of childhood-onset schizophrenia. […] The main treatment modality in schizophrenia is pharmacological in both children and adults. Antipsychotic drugs are the first-line of treatment and atypical antipsychotics should be preferred to typical antipsychotics as they show at least the same efficacy and a better tolerability in childhood-onset schizophrenia. […] Recent randomized controlled trials have shown the efficacy of some atypical antipsychotics in childhood-onset schizophrenia. […] As a result, aripiprazole, olanzapine, quetiapine, paliperidone and risperidone have received formal indications for the treatment of schizophrenia between the ages of 13-17 years.

• #2 Childhood-Onset Schizophrenia Medication: First Generation Antipsychotics (Typical), Second Generation Antipsychotics (Atypical), Benzodiazepines, Antiparkinsonian Agents, Antihistamines, Beta-adrenergic Blockers, Dopamine Agonist

  https://emedicine.medscape.com/article/914840-medication

  Historically, atypical antipsychotics are the first-line therapy for individuals with childhood-onset schizophrenia. […] Many second-generation antipsychotics have been approved by the FDA in recent years for adolescents to treat schizophrenia including aripiprazole, lurasidone, olanzapine, quetiapine, paliperidone, and risperidone. […] Generally, second generation antipsychotics are chosen as first-line antipsychotic therapy. As of February 2017, aripiprazole, lurasidone, olanzapine, quetiapine, risperidone, and paliperidone have been FDA approved for treatment of schizophrenia in adolescents. […] Several studies have been performed investigating the efficacy of atypical antipsychotics in the treatment of childhood-onset schizophrenia. […] Aripiprazole shown beneficial as maintenance therapy in adolescents, delaying time to exacerbations of psychotic symptoms compared to placebo.

• #2 Childhood-Onset Schizophrenia Medication: First Generation Antipsychotics (Typical), Second Generation Antipsychotics (Atypical), Benzodiazepines, Antiparkinsonian Agents, Antihistamines, Beta-adrenergic Blockers, Dopamine Agonist

  https://emedicine.medscape.com/article/914840-medication

  Despite these risks and concerns, clozapine is generally safe and effective in the treatment of refractory early onset schizophrenia. […] A systematic review and Network Meta-Analysis, ziprasidone was found to have limited or no effect on decreasing total and positive symptoms in the treatment of schizophrenia in patients less than nineteen years old. […] In the treatment of early-onset schizophrenia spectrum disorders (TEOSS) study, the efficacy of olanzapine and risperidone was compared with molindone (a first-generation antipsychotic medication) in the treatment of early-onset schizophrenia and schizoaffective disorder in a double-blind multisite trial. […] Weight gain has been a problem with all currently available atypical antipsychotics, although weight gain may be less of a problem with ziprasidone. Pediatric patients with childhood-onset schizophrenia are already at higher risk for obesity and metabolic syndrome. Prescribing second-generation antipsychotics may put these patients at even greater risk for weight-gain and development of metabolic syndrome. Its suggested clinicians consider the addition of metformin when initiating pediatric patients on second-generation antipsychotics. This is not yet standard of care, but could be considered based on clinical circumstances.

• #2 Medications for childhood and early-onset schizophrenia – NeuRA Library

  https://library.neura.edu.au/schizophrenia/treatments/physical/pharmaceutical/treatments-for-specific-symptoms-and-populations/treatments-for-childhood-and-early-onset-schizophrenia/index.html

  Moderate quality evidence finds a small to medium-sized benefit of second-generation antipsychotics for global and mental state in children and adolescents with schizophrenia. […] Moderate quality evidence finds clozapine was the most effective antipsychotic and fluphenazine was the least effective antipsychotic for symptoms when compared to placebo and other antipsychotics. […] For positive symptoms in particular (e.g. hallucinations and delusions), moderate to high quality evidence finds medium-sized improvements with olanzapine, risperidone, and asenapine, and small improvements with quetiapine, aripiprazole, and paliperidone over placebo. […] Moderate quality evidence finds haloperidol, loxapine, risperidone and quetiapine resulted in the most extrapyramidal (movement) symptoms. […] Moderate quality evidence finds supportive therapy is better than cognitive behavioural therapy for improving symptoms, however cognitive behavioural therapy is better than supportive therapy for improving insight in children with early-onset schizophrenia.

• #2 Mayo Clinic Health Library – Childhood schizophrenia | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20199576

  Treatment plans that include building life skills can help your child function at age-appropriate levels when possible. Skills training may include social and academic skills training and vocational rehabilitation and supported employment. […] During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your child’s safety and make sure that he or she is getting proper nutrition, sleep, and hygiene.

• #2 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02581

  Specialized educational or structured activity programs. These may include social skills training, vocational training, and speech and language therapy. […] Self-help and support groups. These can help the child learn ways to cope with the disorder and also work on social skills. […] Treatment can include a combination of medicine, therapy, and special programs.

• #2 Schizophrenia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/schizophrenia

  While schizophrenia is a chronic disorder that requires lifelong management, there is hope. With proper treatment, many children with schizophrenia are able to go to college, hold jobs and have families as adults. […] As one of the largest pediatric psychiatric services in New England, Boston Childrens has an experienced team of expert child psychologists, psychiatrists, neuropsychologists, social workers and other clinicians with extensive experience treating schizophrenia. We will work with you to design a treatment plan that not only meets the individual needs of your child, but also supports the emotional well-being of the entire family. […] We understand the many components involved in treating childhood schizophrenia, from medically managing the symptoms of the disease to educating family members and educators and locating resources in the community. Beginning with the initial diagnosis, your Boston Childrens team will explain the treatment options available to you and your child and help you identify the medications, educational and activity programs and family support systems you need.

• #2 Clinical Practice Guidelines for the Management of Schizophrenia in Children and Adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6345123/

  Psychosocial interventions […] Psychosocial interventions are integral part of management of schizophrenia. Various psychosocial interventions which have been found to be useful in the management of schizophrenia in adult patients include family interventions, cognitive behavioral therapy (CBT), cognitive remediation therapy (CRT), social skills training, individual supportive therapy, group therapy, vocational rehabilitation, case management, and use of community mental health teams and of crisis resolution teams. Occasional studies have also evaluated CRT, CBT, and family intervention/psychoeducation in patients with EOS, and the available data suggest that CRT is useful in the management of EOS. Studies which have integrated the components of problem-solving, psychoeducation, and family intervention have also shown the beneficial effect of the same in improving the outcome of patients with schizophrenia.

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