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\"Psychosis in Childhood and Adolescence offers an in-depth examination of the nature of psychosis, its risk factors and its manifestations in children and adolescents who experience a continuum of emotional disorders. The chapters present a hopeful, research-based framework for treatment. They emphasize combined treatment that is based on psychodynamic and cognitive behavioral psychotherapy principles, pharmacological interventions and supportive family approaches that reflect the vulnerabilities and resources of the individual child. This text highlights the importance of thorough assessment and the need for long-term treatment that facilitates the psychotic child's healthy maturation. Readers will benefit from the case examples that illustrate the complexity of psychosis and the discussions of diagnostic and treatment issues as presented by experienced clinicians and researchers\"--Provided by publisher.

Early-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited. To provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P. PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle-Ottawa Scale. Of 3289 articles, 133 were included ( = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%-75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3-92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication. Negative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available.

Abstract The prevalence of negative symptoms (NS) at first episode of early-onset psychosis (EOP), and their effect on psychosis prognosis is unclear. In a sample of 638 children with EOP (aged 10–17 y, 51% male), we assessed (1) the prevalence of NS at first presentation to mental health services and (2) whether NS predicted eventual development of multiple treatment failure (MTF) prior to the age of 18 (defined by initiation of a third trial of novel antipsychotic due to prior insufficient response, intolerable adverse-effects or non-adherence). Data were extracted from the electronic health records held by child inpatient and community-based services in South London, United Kingdom. Natural Language Processing tools were used to measure the presence of Marder Factor NS and antipsychotic use. The association between presenting with ≥2 NS and the development of MTF over a 5-year period was modeled using Cox regression. Out of the 638 children, 37.5% showed ≥2 NS at first presentation, and 124 (19.3%) developed MTF prior to the age of 18. The presence of NS at first episode was significantly associated with MTF (adjusted hazard ratio 1.62, 95% CI 1.07–2.46; P = .02) after controlling for a number of potential confounders including psychosis diagnostic classification, positive symptoms, comorbid depression, and family history of psychosis. Other factors associated with MTF included comorbid autism spectrum disorder, older age at first presentation, Black ethnicity, and family history of psychosis. In EOP, NS at first episode are prevalent and may help identify a subset of children at higher risk of responding poorly to antipsychotics.

Background Children and adolescents represent a highly vulnerable and crucial demographic in the field of mental health research. Unfortunately, suicide remains one of the leading causes of death among teenagers worldwide. While symptoms of psychotic-like experiences (PLEs) are often linked to increased suicidal ideation, school connectedness has been shown to mitigate such risks and promote emotional well-being. Although the association between PLEs and suicidal thoughts is well-documented, there is still a need to further investigate how school connectedness interacts with both PLEs and suicidal ideation to provide a more comprehensive understanding of these relationships. Methods This study employed network analysis to examine the relationships between psychosis-like experiences (PLEs), school connectedness, and suicidal ideation in a sample of 10,409 children and adolescents from five cities in Guangxi Zhuang Autonomous Region of China. Data on PLEs (CAPE-P15), suicidal ideation (PANSI), and school connectedness were collected through self-report questionnaires. The data were analyzed via the R language software package to evaluate the correlations involved in school connectedness within the network. Results The network analysis indicates that J6 (school connectedness) and D1 (persecutory ideation) are the key nodes of the network. The path of J6 (school connectedness) → G14 (confidence in the future) → suicidal ideation buffers the influence of PLEs. D1 (persecutory ideation) is associated with G3 (Hopelessness) → suicidal ideation. J5 (Teacher support) and J1 (Peer support) alleviate suffering through indirect effects. G3 (Hopelessness) and G12 (Defeat and suicidal thoughts) occupy the core position in the cluster of suicidal ideation. Enhancing school connectedness and reducing paranoia of being victimized are crucial for preventing suicide. Conclusion This study confirmed that school connectedness is associated with PLEs and suicidal ideation. The findings suggest that school-based programs (peer mentoring, teacher support training, and cognitive restructuring) are effective suicide prevention strategies. Future research should explore longitudinal changes and cultural variations to refine interventions and ensure the sustainability of children’s and adolescents’ mental health improvements.

Anecdotal evidence of successful cannabis treatment in autism spectrum disorder (ASD) are accumulating but clinical studies are lacking. This retrospective study assessed tolerability and efficacy of cannabidiol-rich cannabis, in 60 children with ASD and severe behavioral problems (age = 11.8 ± 3.5, range 5.0–17.5; 77% low functioning; 83% boys). Efficacy was assessed using the Caregiver Global Impression of Change scale. Adverse events included sleep disturbances (14%) irritability (9%) and loss of appetite (9%). One girl who used higher tetrahydrocannabinol had a transient serious psychotic event which required treatment with an antipsychotic. Following the cannabis treatment, behavioral outbreaks were much improved or very much improved in 61% of patients. This preliminary study supports feasibility of CBD-based cannabis trials in children with ASD.

Mental health problems, such as depression in children have far-reaching negative effects on child, family and society as whole. It is necessary to identify the reasons that contribute to this mental illness. Detecting the appropriate signs to anticipate mental illness as depression in children and adolescents is vital in making an early and accurate diagnosis to avoid severe consequences in the future. There has been no research employing machine learning (ML) approaches for depression detection among children and adolescents aged 4-17 years in a precisely constructed high prediction dataset, such as Young Minds Matter (YMM). As a result, our objective is to 1) create a model that can predict depression in children and adolescents aged 4-17 years old, 2) evaluate the results of ML algorithms to determine which one outperforms the others and 3) associate with the related issues of family activities and socioeconomic difficulties that contribute to depression. The YMM, the second Australian Child and Adolescent Survey of Mental Health and Wellbeing 2013-14 has been used as data source in this research. The variables of yes/no value of low correlation with the target variable (depression status) have been eliminated. The Boruta algorithm has been utilized in association with a Random Forest (RF) classifier to extract the most important features for depression detection among the high correlated variables with target variable. The Tree-based Pipeline Optimization Tool (TPOTclassifier) has been used to choose suitable supervised learning models. In the depression detection step, RF, XGBoost (XGB), Decision Tree (DT), and Gaussian Naive Bayes (GaussianNB) have been used. Unhappy, nothing fun, irritable mood, diminished interest, weight loss/gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, thinking or concentration problems or indecisiveness, suicide attempt or plan, presence of any of these five symptoms have been identified as 11 important features to detect depression among children and adolescents. Although model performance varied somewhat, RF outperformed all other algorithms in predicting depressed classes by 99% with 95% accuracy rate and 99% precision rate in 315 milliseconds (ms). This RF-based prediction model is more accurate and informative in predicting child and adolescent depression that outperforms in all four confusion matrix performance measures as well as execution duration.

Background Childhood maltreatment and trauma (CMT) increase the risk for schizophrenia spectrum disorders (SSDs) and the severity of psychosis symptoms. Few studies have considered the possible influence of parental mental health on the relationship between CMT and symptoms of psychosis. Possibly, parental mental health problems (MHP) confound this relationship by increasing both the genetic vulnerability for psychosis and the potential for sub-optimal childhood environments. The aim was to examine the potential influence of parental MHP on the relationship between CMT and symptoms of psychosis. We hypothesized a positive and dose-dependent association between overall CMT and symptoms of psychosis not moderated by parental MHP. Methods Patients with SSDs ( N  = 133) from the Bergen-Stavanger-Innsbruck-Trondheim (BeStInTro) study were included and assessed for CMT by the Childhood Trauma Questionnaire - Short Form, psychosis symptoms by The Positive and Negative Syndrome Scale and parental mental health by means of focused patient interviews. Results Regression analyses showed a dose-response relationship between CMT and overall psychosis symptom severity and negative symptom severity, further supported by t-tests showing that SSD patients with CMT showed more psychosis symptoms compared to SSD patients with no CMT. Multiple regression analysis with interaction term showed that the association between CMT and psychosis symptom severity was independent, and not moderated, by parental MHP. Conclusion A dose-dependent relationship between CMT and psychosis symptoms emerged, not moderated by parental MHP, suggesting that CMT has an independent and true effect on psychosis symptoms.

The evaluation of childhood trauma is essential for the treatment of schizophrenia. The short form of Childhood Trauma Questionnaire (CTQ-SF) is a widely used measure of the experience of childhood trauma in the general population. Nevertheless, data regarding the psychometric property of CTQ-SF for assessing childhood trauma of patients with schizophrenia are very limited. Two hundred Chinese inpatients with schizophrenia completed the Chinese CTQ-SF, the Child Psychological Maltreatment Scale (CPMS), the Impact of Events Scale-Revised (IES-R), and the Dissociative Experiences Scale-II (DES-II). To assess test-retest reliability of the CTQ-SF, all patients completed the CTQ-SF again two weeks later. Concurrent and convergent validity was assessed by analyzing Pearson bivariate correlation coefficients between CTQ-SF and CPMS, IES-R, and DES-II. The Cronbach's α coefficient of the Chinese CTQ-SF was 0.81, and the two-week re-test reliability was 0.81 (P<0.01). The criterion-related validity coefficients of CTQ-SF with the CMPS, IES-R and DES-II were 0.61, 0.41, and 0.51, respectively. The Chinese CTQ-SF has satisfactory psychometric properties to measure childhood abuse or neglect in Chinese inpatients with schizophrenia.

Background While expansive research has accumulated concerning the association between traditional, face-to-face peer victimization and psychosis, a paucity of empirical research has been undertaken so far to investigate these associations with experiences of new and evolving ways of victimization through the digital world. Exploring these associations is highly relevant and timely, given that emerging adults are heavy users of digital technologies, highly exposed to online risks, and are at the peak age of onset of psychosis. This study aimed to test the hypothesis that psychological distress and insomnia symptoms have a significant indirect mediating effect on the association between cyber-victimization and self-reported positive psychotic experiences (SRPEs) in a binational sample of Tunisian and Lebanese community adults. Method The total sample was composed of 3766 participants; 3103 were from Lebanon (Mean age: 21.73 ± 3.80 years, 63.6% females) and 663 from Tunisia (Mean age: 26.32 ± 4.86 years, 59.9% females). Online anonymous self-report questionnaires were administered to all participants. Results Higher SRPEs were found in Lebanese participants compared to Tunisians, in single participants compared to married ones, in those with a university level of education compared to secondary or less, in those who live in rural areas compared to urban, in those who do not smoke, do not drink alcohol and do not use marijuana or any other illegal drug. Furthermore, more cyber-victimization, a higher insomnia severity and psychological distress were significantly associated with higher SRPEs. After adjusting for potential confounders, mediation analysis demonstrated that higher cyber-victimization was significantly associated with more insomnia severity/psychological distress; which were, in turn, significantly associated with greater SRPEs. Finally, more cyber-victimization was significantly and directly associated with more positive dimension. Conclusion Identifying insomnia and distress as mediators could provide novel insight for psychosis prevention efforts and intervention targets for cyber-victimized individuals prone to experience subclinical psychotic symptoms.