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Current Treatment Trends of Psychosis in Youth with Schizophrenia

Authors:
Krista Baker
Krista Baker
Carolyn Howell
Carolyn Howell
Carolyn Howell
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Robert L. Findling
Robert L. Findling
Robert L. Findling
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Abstract

Opinion statement Given the current state of the literature, we recommend using evidence-based antipsychotic selection and empirically supported dosing for medications, data for which have only recently become available. Despite the paucity of evidence supporting psychosocial interventions in youth with psychosis, we extrapolate effectiveness conclusions from both the first-episode psychosis and the adult literature. We recommend interventions such as cognitive behavioral therapy, social skills, multi-family group therapy, and some briefer forms of cognitive rehabilitation training. Additionally, we have found that some combination of psychiatric rehabilitation programs, case management, and supported vocational/academic programs enhance functioning and subjective quality of life in our own patients. It is our recommendation that the decision whether or not to prescribe pharmacological interventions for the clinically high risk/prodromal youth be decided on a case by case basis, but that psychosocial interventions and family support for this population should be employed during this period of vulnerability.
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Curr Treat Options Psych (2016) 3:1–14
DOI 10.1007/s40501-016-0066-9
Child and Adolescent Psychiatry (M DelBello, Section Editor)
Current Treatment Trends
of Psychosis in Youth
with Schizophrenia
Krista Baker, LCPC
1
Carolyn Howell, MD
1
Robert L. Findling, MD, MBA
2,3,*
Address
1
Johns Hopkins Bayview Medical Center, 5200 Eastern Avenue, MFL-D2E, Balti-
more, MD, 21224, USA
*,2
Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA
Email: rfindli1@jhmi.edu
3
Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD, 21205, USA
Published online: 12 February 2016
*Springer International Publishing AG 2016
This article is part of the Topical Collection on Child and Adolescent Psychiatry
Keywords Early psychosis IFirst episode psychosis ISchizophrenia prodrome IAntipsychotics in youth IPsychosocial
interventions in youth schizophrenia
Opinion statement
Given the current state of the literature, we recommend using evidence-based antipsy-
chotic selection and empirically supported dosing for medications, data for which have
only recently become available. Despite the paucity of evidence supporting psychosocial
interventions in youth with psychosis, we extrapolate effectiveness conclusions from both
the first-episode psychosis and the adult literature. We recommend interventions such as
cognitive behavioral therapy, social skills, multi-family group therapy, and some briefer
forms of cognitive rehabilitation training. Additionally, we have found that some combi-
nation of psychiatric rehabilitation programs, case management, and supported
vocational/academic programs enhance functioning and subjective quality of life in our
own patients. It is our recommendation that the decision whether or not to prescribe
pharmacological interventions for the clinically high risk/prodromal youth be decided on a
case by case basis, but that psychosocial interventions and family support for this
population should be employed during this period of vulnerability.
Introduction
Youth-onset schizophrenia (onset prior to age 18) is a
serious illness that can have a devastating course if it is
not treated early and comprehensively. Childhood-onset
schizophrenia (COS) is defined as onset prior to age 13
and is a rarer and more malignant expression of illness.
COS is more frequently associated with higher genetic
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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... Robin comprises individual therapy, family sessions, and a smartphone application for supporting patients between sessions. The therapy modules are based on treatment strategies in CHR adults (6,14,(42)(43)(44) and recommendations for adolescents with first episodes of psychosis (33,45,46). It follows the guidance on early intervention in CHR states of psychosis of the European Psychiatric Association (EPA) (15). ...
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