Appunti di Neuropsichiatria
La psicosi e i disturbi psicotici nei bambini e negli adolescenti
Psychosis and psychotic symptoms in children and adolescents
Giorgia Gamberini, Ilaria Secci, Benedetto Vitiello
Sezione di Neuropsichiatria Infantile, Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Ospedale Infantile “Regina Margherita”, Università di Torino
Febbraio 2022 - pagg. 103 -113 | DOI: 10.53126/MEB41103
Abstract
Psychosis can present a variety of symptoms such as hallucinations, delusions, catatonia, thought and speech disorganization, alogia, avolition and general functional decline. Transient psychotic symptoms are not uncommon during development and are not always indicative of psychopathology. Psychosis can be a manifestation of a schizophrenia spectrum disorder, or occur in the context of a mood disorder, such as major depression or bipolar mania. It can also be due to substance abuse or certain medical conditions, such as the NMDA encephalitis. Most cases of schizophrenia start between 15 and 25 years of age, while an onset under age 13 is rare. Schizophrenia tends to have an insidious onset with many months of subsyndromal and non-specific symptoms prior to the first openly psychotic episode. Repeated use of cannabis in youth increases the risk of psychosis, since the developing brain is especially sensitive to the psychoactive effects of tetrahydrocannabinol. As the duration of untreated psychosis predicts worse functional outcomes over time, a prompt recognition and early treatment of psychotic disorders has high clinical relevance. To this end, a close collaboration between paediatricians and child and adolescent neuropsychiatrists is crucial
Riassunto
Avere sintomi psicotici non equivale ad avere un disturbo psicotico. Nel bambino, sintomi psicotici isolati e transitori non sempre hanno un significato patologico. La psicosi può essere una manifestazione di un disturbo dello spettro schizofrenico, ma anche di altre problematiche come i disturbi dell’umore, l’abuso di sostanze, o l’encefalite con anticorpi anti recettore NMDA. La schizofrenia ha di solito esordio tra i 15 e i 25 anni (in circa il 12% prima del 18° anno), mentre è molto rara prima dei 13 anni. L’esordio schizofrenico è insidioso, con mesi e a volte anni di sintomi sottosoglia o non specifici. Una pronta identificazione della schizofrenia può consentire un trattamento precoce che potrebbe migliorare la prognosi.
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Corrispondenza: benedetto.vitiello@unito.it