Psychotic disorders in childhood: characteristics, types and symptoms

Psychotic disorders comprise mental disorders characterized mainly by causing unusual ideas and perceptions, so the loss of contact with reality is quite striking. The main symptoms include hallucinations and delusions and, although there is more research on cases developed in adulthood, they can also begin in childhood.

Psychotic disorders in childhood would be included within the general classification of schizophrenia and other psychotic disorders. However, there are a number of differences in this type of case with respect to those that develop in adulthood, so it is convenient to talk about it and explain its characteristics.

In this article We will see what are the main characteristics of psychotic disorders in childhood, in order to be able to distinguish them from those that develop in adulthood.

• Related article: "What is schizophrenia? Symptoms and treatments"

Psychotic disorders and their characteristics

In the first cases of schizophrenia, diagnosed by Bleuler and Kraepelin, it was possible to observe an onset in childhood and/or adolescence, with Mahler, who some years later, he came to make a description of psychotic disorders in childhood under the name of "symbiotic childhood psychosis", characterized by being a fusion somatic and psychic of a hallucinatory and omnipotent nature with the mother, which would therefore imply a denial of a common border between two separate subjects physically.

Currently, there is no specific category for childhood psychotic disorders within the classifications international, but this type of cases would be included within the general classification of schizophrenia and other disorders psychotic Nevertheless, There are a number of differences between this type of case and those that develop in adulthood., so we will talk about it soon.

The positive symptoms

Within the positive symptomatology of psychotic disorders in childhood noteworthy delusions that, although they are usually less elaborate than in the case of adults, they acquire a greater degree of systematization as the child grows. The most common delusions in childhood are usually persecutory, although they also occur quite frequently. somatic or hypochondria delusions, regency delusions, bizarre delusions, and lastly, greatness.

On the other hand, hallucinations are also usually quite frequent, although they also have a lower degree of elaboration than those that usually occur during adulthood. Within this category, we can highlight the auditory and visual hallucinations (the latter appear to a lesser extent than the former). On the other hand, we can also find non-affective hallucinations, hallucinations related to commands, visual hallucinations, and hallucinations about talking voices.

Other of the most characteristic positive symptoms within psychotic disorders in childhood are the disorganization of speech, when the child shows an illogical, incomprehensible and incoherent; the disorganization of thought, when it shows aggressiveness, restlessness and lack of self-care; finally, catatonic symptoms, which are a series of motor alterations by default or even by excess, or shows unusual body postures.

They also often show emotions that are not in accordance with the situation or that there is an emotional impoverishment, expressing very few emotions.

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The negative symptoms

Among the negative symptoms of psychotic disorders in childhood, it is worth highlighting the existence of little or poor language for their age, some maladaptive behaviors, isolation, poor social integration with other children due to difficulty in establishing and/or maintaining relationships, affective resonance and little expressiveness, apathy, abulia or anhedonia, among others.

When a child suffers from a psychotic disorder, it is common for them to be experiencing a notable deterioration in the functioning that corresponds to their age or stage of development, since a serious disturbance of the organization of his personality usually develops, so there is an obstacle to understanding reality, among other consequences that require professional attention.

• Related article: "What is psychosis? Causes, symptoms and treatment"

What are psychotic disorders in childhood?

Psychotic disorders in childhood are made up of a series of symptoms, whether positive or negative, such as those we saw earlier and being characterized fundamentally due to the fact that the child who suffers from any of them experiences a notable alteration in the perception of reality, and also in the emotions and in their thoughts.

Thus, it is necessary to treat it as soon as possible and opt for an integrated or multimodal treatment (psychotherapy, psychopharmacology and even psychopedagogy) in order to establish a therapeutic model in the medium and long term in order to achieve a stabilization of symptoms and disruptive behaviors, as well as to help the child to develop levels of functioning acceptable.

It should be noted that, to date, no single or exact causes have been found for the development of psychotic disorders in childhood. However, several experts warn of the existence of a series of factors to take into account that, given in combination, can favor its childhood development: genetic factors, family history of psychosis, growing up in a negative environment, living negative experiences, consumption early use of alcohol and/or drugs, some problems or complications during pregnancy, some abnormalities in structure and some functions cerebral, etc.

Next, we will briefly explain some of the most common psychotic disorders during childhood.

1. Acute psychotic break

One of the psychotic disorders in childhood would be the acute psychotic outbreak, in which it is common to detect a verbose and overflowing language, having in addition an apparently meaningless and unconnected communication.

In this type of case, the most common symptoms are delusions and hallucinations, and are also characterized by presenting during a prolonged period. of shorter time than in other types of psychotic disorders (approximately 1 month duration compared to other disorders that usually last more than 1 month).

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2. dysharmonic psychosis

Disharmonic psychosis could develop after 4 years of age and is characterized by the sample of unusual and not at all harmonious postures (p. g., keeping the child still in a position that gives the feeling that he is petrified). It is also common that there are some deficits in certain areas of learning, in the body scheme, difficulties in when locating oneself in time and space, as well as certain difficulties related to language and laterality.

• Related article: "Hallucinations: definition, causes, and symptoms"

3. deficit psychosis

In this case of psychoses of deficit expression, it has been observed that they present a cognitive deficit and also in learning. In addition, it is common for them to externalize psychotic anguish and to show a series of impulsive behaviors and self-injurious characteristics, as well as a certain dissociation at the psychological level. In these types of cases, upon reaching adolescence, it has been observed that it is quite common for them to present a series of episodes of polymorphous delusion, characterized by an association of delusional ideas of a specific nature diverse.

4. schizophrenia in adolescence

Schizophrenia in adolescence, also known as early schizophrenia, It is one that usually begins to develop before the age of 13. old. In this type of case, there are usually symptoms characteristic of schizophrenia in adulthood, such as positive symptomatology (p. g., hallucinations, delusions, etc.), as well as the negative (p. g., impoverishment of performance and of some capacities of the subject such as the negative symptoms of psychotic disorders that we mentioned above).

5. Attenuated psychosis syndrome

The attenuated psychosis syndrome is a disorder that is located in the Diagnostic and Statistical Manual of the Mental Disorders (DSM-5) within Section III (Conditions that need further study), so it is important include it here.

This syndrome is made up of a series of symptoms that are also characteristic of schizophrenia (eg. g., disorganized speech, hallucinations, delusions, etc.); however, in the case of attenuated psychosis syndrome these symptoms occur for a shorter duration and have lower levels of severity. In addition, in this type of case, the people who suffer from it tend to have a greater degree of introspection and awareness of the problem, although they are still noticeable enough to cause some distress and even clinical disability.

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6. Childhood Borderline Syndrome or Multiple Developmental Disorder

Another of the psychotic disorders in childhood that should be discussed is the borderline syndrome, also known as multiple developmental disorder, characterized by a series of conditions at different levels.

In this syndrome there are usually a series of difficulties at a social level, so their social relationships may be affected, leading to isolation; certain difficulties in differentiating fantasy from reality and also in organizing one's own thoughts; problems regulating anxiety, acts of impulsivity or difficulties concentrating, among others.

High-risk mental states

The name of high-risk mental states has been used to refer to those syndromes that, once detected, indicate a risk of evolution towards psychotic disorders in childhood, its appearance being inevitable in some cases, although treatment by a team is still important professional as soon as possible in order to provide the tools to both the parents and the child so that he can have a full life.

Some experts who have investigated high-risk mental states have established 3 subcategories:

• In which there is a family history of psychosis.
• History in the child of limited psychotic symptoms and for a short time.
• Existence of psychotic symptoms at fairly attenuated levels.