Children who present with a psychotic selleck kinase inhibitor depression may also appear to have impoverished thoughts and social withdrawal; however, the mood symptoms are expected to improve with resolution of the episode. In contrast, the negative symptoms of schizophrenia may not improve with resolution of the episode. In children presenting with psychosis in the context of depression, 50% to 60% will develop BPAD, and their risk for suicide is markedly increased.20,21 Schizoaffective disorder As the name implies, schizoaffective Inhibitors,research,lifescience,medical disorder shares many symptoms with the affective disorders, which can complicate the diagnosis. In the initial phases of psychotic illness in children and

adolescents, affective symptoms related to adjustment and demoralization may overshadow the presence of psychotic symptoms. According to DSM-IV-TR, delusions or hallucinations of 2 weeks’ duration must occur in the absence of mood symptoms to distinguish Inhibitors,research,lifescience,medical schizoaffective disorder from a mood disorder with psychotic features.

Inhibitors,research,lifescience,medical Traditionally, the diagnosis of schizophrenia has relied on the presence of bizarre hallucinations or delusions instead of mood-congruent hallucinations or delusions related to BPAD or MDD. However, the determination of “mood congruent” at times appears too subjective. For instance, youngsters who initially present with mood-incongruent Inhibitors,research,lifescience,medical hallucinations, marked thought disorder, and paranoia have later been diagnosed with BPAD as prominent mood cycling appeared.18 In contrast, some children initially diagnosed with schizoaffective disorder on the basis of prominent mood symptoms later develop significant symptoms of thought disorder, while the mood symptoms only accompany the psychotic episodes. Schizoaffective disorder is associated with the poorest outcome and chronic impairment in children.17 Inhibitors,research,lifescience,medical Psychosis not otherwise specified The diagnostic category of PNOS may be used

by default when full criteria are lacking for psychotic disorders in the schizophrenic or mood disorders spectrum. There are divergent old opinions about the validity of PNOS. The diagnosis is sometimes given to children who present with self-reports of hallucinations and/or delusions in the absence of a formal thought disorder, severe mood disturbance, or other clinical context suggesting a state of psychosis. The validity of self-reported hallucinations and delusions was questioned in a study of children diagnosed with PNOS with brief psychotic episodes and hallucinations, but without formal thought disorder or psychotic behaviors.22 One group of researchers found high incidence of physical/sexual abuse in children diagnosed with PNOS,23 and suggested a scenario of dissociative symptoms accounting for the self-report symptoms.