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4. Week 13: Psychotic Disorders
5. Week 13: Group-Facilitated Discussion 1 – Group 4
6. Week 13: Group-Facilitated Discussion 1 – Group 4

Week 13: Group-Facilitated Discussion 1 – Group 4

Week 13: Group-Facilitated Discussion 1 – Group 4

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Week 13: Group-Facilitated Discussion 1 – Group 4

by Devashish Rattan – Tuesday, 24 January 2023, 4:16 AM

Number of replies: 8

Please use this thread to create your reply posts, as indicated in the forum instructions.

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Re: Week 13: Group-Facilitated Discussion 1 – Group 4

by Meghan Bronkema – Monday, 24 July 2023, 2:36 AM

We are so close everyone! Welcome to Week 13!

Psychosis can appear during the developmental stages of adolescence and childhood, despite being frequently associated with adults. This presents special challenges and considerations for diagnosis, treatment, and long-term outcomes. To minimize its effects on a person’s overall well-being and prospects, early intervention and effective management of psychosis in this population are essential.

For reducing the long-term effects of psychosis and encouraging healthy futures, it is essential to recognize the special difficulties these demographic faces and to put early intervention techniques into place. We may work to support young people with psychosis in a more compassionate and efficient manner by promoting awareness, research, and access to specialist care.

For your original discussion post this week, please read the following articles in addition to the assigned readings this week, and craft an original post using one or more of the following prompts:

1. Compare and contrast childhood vs adolescent symptom presentation & treatment.2. Recommended psychopharmacological vs complementary treatment for psychosis.3. Discuss screening tools & recommended therapeutic interventions.4. Discuss how psychotic symptoms in childhood can be commonly misdiagnosed as schizophrenia and how to disentangle these.

Please reply to two separate peer posts on two separate days, using the following prompts:1. Propose several ways to support a child/adolescent and their caretakers at onset of illness. Please use two new resources.2. Discuss how stigma surrounding psychotic disorders can contribute to the child/adolescent patient with psychotic disorders and how we as PMHNPs can work in our practice to address this stigma.Recommended Readings:Bhatara, V. S., Daniel, J., Whitman, C., Vik, T., Bernstein, B., & Simkin, D. R. (2023). Complementary/Integrative medicine treatment and prevention of youth psychosis. Child and Adolescent Psychiatric Clinics of North America, 32(2), 273–296. https://doi.org/10.1016/j.chc.2022.08.009

Carroll D, Wales M, Rintell LS, et al. Burden experienced by primary caregivers of children with psychotic disorders and at clinical high risk for psychosis. Journal of the American Psychiatric Nurses Association. 2022;0(0). doi:10.1177/10783903221141883

Morales-Muñoz, I., Palmer, E. R., Marwaha, S., Mallikarjun, P. K., & Upthegrove, R. (2022). Persistent childhood and adolescent anxiety and risk for psychosis: A longitudinal birth cohort study. Biological Psychiatry, 92(4), 275–282. https://doi.org/10.1016/j.biopsych.2021.12.003

Schultze-Lutter, F., Kindler, J., Ambarini, T. K., & Michel, C. (2022). Positive psychotic symptoms in childhood and adolescence. Current Opinion in Psychology, 45, 101287. https://doi.org/10.1016/j.copsyc.2021.11.007

Stevens, J. R., Prince, J. B., Prager, L. M., & Stern, T. A. (2014). Psychotic disorders in children and adolescents: a primer on contemporary evaluation and management. The Primary Care Companion for CNS disorders, 16(2), PCC.13f01514. https://doi.org/10.4088/PCC.13f01514The following video will be useful as well   

 

This is the instruction  I am the non – facilitated group, I am replying to my classmate’s post

NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I

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2. My courses
3. NU-664C-02-23PCS3
4. Week 7: Population Health and Mental Health
5. Week 7 Get Started: Group-Facilitated Discussion Board Instructions

Week 7 Get Started: Group-Facilitated Discussion Board Instructions

To do:Make forum posts: 1

Value: No grade this week; 100 points when submitted

Due: Week 8, Day 7

Overview

The purpose of this assignment is for student groups to demonstrate the ability to collaborate, design, and create a group-facilitated discussion plan. Once the plan is complete, each group will use their plan to teach fellow classmates about the group’s presentation topic.

Step 1: Groups

Check the roster or course announcements for your randomly chosen group number and specific presentation topic. The assigned presentation weeks for your groups are noted below.

Each group member should read the details of this assignment and be prepared to work with the group to complete the group-facilitated discussion plan.

Presentation Weeks: The weekly topics and presentation weeks are:

• Group 1: Week 10 – Depression and Somatization Disorders
• Group 2: Week 11 – Anxiety Disorders
• Group 3: Week 12 – Mood Disorders (Bipolar Spectrum)
• Group 4: Week 13 – Psychotic Disorders
• Group 5: Week 14 – ADHD

Step 2: Connect

Connect with your group in the appropriate group thread in this discussion forum. Each group is more than welcome to continue using this discussion forum for the entire assignment.

During the initial meeting, determine the best way to proceed with this assignment as a group. Determine how often you will meet, the responsibilities of each group member, and on which meeting tool you would like to use if not this Discussion forum. (for example, Google Hangouts, Zoom, etc.).

Step 3: Create the group-facilitated discussion plan.

• Remember that the group-facilitated discussion plan topic needs to be based on the child and adolescent populations.
• This plan will be used during the topic discussion week and should elicit a thought-provoking discussion for your classmates.
• Each member of the group is to explore and locate several resources regarding the group topic for the group members to review.
• Once all resources have been reviewed by the group, the group will determine which resources, (a minimum of four resources (literature reviewed articles, videos, and the like) will be included as a part of you’re the group-facilitated discussion plan. These resources are needed to provide content for you’re the peers to review as a part of their participation in the discussion.
• As a group, determine the details you want to present to your peers.
• Once the resources have been reviewed and decided upon within the group, four teaching/learning discussion prompts should be created for fellow classmates to answer during their participation in the discussion.
• Make sure each group member shares about the same workload.
• Your plan should include the following:

1. A summarized overview of the topic.
2. At least four resources that you will be asking your classmates to review.
3. Four discussion prompts you plan to use to facilitate the discussion.
4. Any resources that you used in preparing your discussion prompts.
5. Remember to use APA format.

Step 4: Submit the group-facilitated discussion plan for grading in Week 8.

• Each student will upload the plan to the Week 8 Assignment 2: Group-Facilitated Discussion Plan Submission. Your faculty will provide group feedback for your review. Your group may be required to make revisions and resubmit. If revisions are needed, it will be noted in the grading rubric.

For ideas on how to structure your discussion, including resources to help your classmates learn, please review this sample discussion prompt: Example of a Good Group Facilitated Discussion (PDF). Note: This sample provides you with guidance on structure, not on content!

Step 5: Group-Facilitated Discussion Presentation Week

• On Day 1 of your selected topic facilitation week, one member of your group will be responsible for posting the following:
  • The presentation of your topic for your classmates to read.
  • Three to four discussion prompts for your classmates to answer. (Example: Please respond to the following questions.)
  • The resources you want your classmates to review.
  • Any instructions that will help your classmates understand what to do for your facilitated discussion.
• During your group-facilitation week, each and every member of your group is to participate in the facilitation of the discussion. This means you are responsible for responding to each classmate’s initial discussion prompt post, making certain that everyone is engaged, questions are being answered, and the discussion is expanding.

Grading of Facilitation Group Work

• Your group will be graded on your facilitation of the discussion, your preparedness for the week, and your responses to your classmates’ posts.

Grading for Non-Facilitating Students

All students who are not facilitating the discussion are responsible for and will be graded on the following:

• Reviewing the discussion materials.
• Responding to the facilitating group discussion prompts.
• Commenting on two additional peers’ posts to create interesting dialog. Your responses should be in-depth and include evidence-based references.  

 

 

These are the two peers that have responded to my group, I’m the non facilitated group so I will reply and say thank you for your post and references , to our discussion post for this week, just to add a few, 

 

Re: Week 13: Group-Facilitated Discussion 1 – Group 4

by Cindy Faraguna – Wednesday, 26 July 2023, 1:37 AM

Compare and contrast childhood vs adolescent symptom presentation & treatment.Presentation in children can be challenging as it may mimic other conditions. Evaluation and treatment of children and adolescents with psychotic symptoms present a formidable challenge for providers due to psychotic symptoms presenting as a medical illness, congenital disorder, substance abuse, or other psychiatric conditions (Algon et al., 2012). Early onset psychosis with onset being before 18 years of age, 90% were diagnosed with schizophrenia (Schultze-Lutter et al., 2022). Psychosis in children and adolescents has been particularly vague because of confusion regarding the developmentally appropriate role of imagination and fantasy in children and adolescents with and without psychiatric disorders (Courvoisie et al., 2001). Children with psychosis rarely demonstrate waxy flexibility or become catatonic like adults, instead, they are emotionally reactive or agitated (Stevens et al., 2014). Early intervention is key to preventing complications into adulthood. Treatment for psychosis includes cognitive behavioral therapy, psychosocial interventions, and medication (Stevens et al., 2014).

Recommended psychopharmacological vs complementary treatment for psychosis.The first line of treatment for psychosis is antipsychotics; however, this may not be suitable or effective for a patient (NHS, 2021). The pharmacologic treatment of psychotic symptoms in a pediatric population is based on the clinician assessing the patient’s symptoms and choosing the proper medication at a sufficient dose and then monitoring therapeutic results while assessing for potential side effects (Stevens et al., 2014). Second-generation antipsychotics, such as olanzapine and risperidone, have been shown to be effective in treating symptoms (Stevens et al., 2014). In controlled studies, the Positive and Negative Syndrome Scale (PANSS) total score results indicated that olanzapine, risperidone, quetiapine, paliperidone, and aripiprazole showed significant improvement compared to placebo (Stevens et al., 2014). Starting pediatric patients on antipsychotics will be initiated at a low dose and gradually titrated to achieve efficacy (Stevens et al., 2014). Quetiapine, aripiprazole, and risperidone are Food and Drug Administration (FDA) approved for mania for ages 10 and up, but off-label for other psychotic disorders (Stahl, 2018). Olanzapine is FDA-approved for 13 years and up for acute/mixed mania and schizophrenia, but off-label use for other psychotic disorders (Stahl, 2018). Paliperidone is FDA-approved for schizophrenia ages 12 and up, but off-label for other psychotic disorders (Stahl, 2018). Antipsychotic treatment for psychotic disorders can have undesired effects. A few studies do suggest that glycine, N-acetyl L-cysteine (NAC), sarcosine, several Chinese and ayurvedic herbs, estradiol, ginkgo biloba, and vitamin B6 may be effective for psychotic symptoms when added to antipsychotics (glycine not when added to clozapine) (Hoenders et al., 2018).Discuss screening tools & recommended therapeutic interventions.An assessment tool that can provide a valid measure of psychotic-like experiences in pediatric patients is the Prodromal Questionnaire–Brief Child (PQ-BC) Version (Karcher et al., 2018). This assessment tool is beneficial in detecting early risk for psychotic disorders (Karcher et al., 2018). CBT is beneficial to help the patient understand their condition and improve insight into psychotic experiences, as well as to improve coping with residual psychotic symptoms (Grover & Avasthi, 2019).Discuss how psychotic symptoms in childhood can be commonly misdiagnosed as schizophrenia and how to disentangle these.Psychotic symptoms can occur with a schizophrenia diagnosis, but not every patient with psychotic symptoms has schizophrenia. Most forms of psychosis in children and adolescents are not a result of schizophrenia (Stevens et al., 2014). Childhood-onset schizophrenia is rare and less than 1 in 10,000 children are diagnosed (Stevens et al., 2014). In children and adolescents, major depression, bipolar disorder, or dissociative states are conditions more likely causes of psychotic symptoms and not schizophrenia (Stevens et al., 2014).

ReferencesAlgon, S., Yi, J., Calkins, M. E., Kohler, C., & Borgmann-Winter, K. E. (2012). Evaluation and treatment of children and adolescents with psychotic symptoms. Current Psychiatry Reports, 14(2), 101–110. https://doi.org/10.1007/s11920-012-0258-y

Courvoisie, H., Labellarte, M. J., & Riddle, M. A. (2001). Psychosis in children: Diagnosis and treatment. Dialogues in Clinical Neuroscience, 3(2), 79–92. https://doi.org/10.31887/dcns.2001.3.2/hcourvoisie

Grover, S., & Avasthi, A. (2019). Clinical practice guidelines for the management of schizophrenia in children and adolescents. Indian Journal of Psychiatry, 61(8), 277. https://doi.org/10.4103/psychiatry.indianjpsychiatry_556_18Hoenders, H. J. R., Bartels-Velthuis, A. A., Vollbehr, N. K., Bruggeman, R., Knegtering, H., & de Jong, J. T. V. M. (2018). Natural medicines for psychotic disorders. Journal of Nervous & Mental Disease, 206(2), 81–101. https://doi.org/10.1097/nmd.0000000000000782

Karcher, N. R., Barch, D. M., Avenevoli, S., Savill, M., Huber, R. S., Simon, T. J., Leckliter, I. N., Sher, K. J., & Loewy, R. L. (2018). Assessment of the prodromal questionnaire–brief child version for measurement of self-reported psychoticlike experiences in childhood. JAMA Psychiatry, 75(8), 853. https://doi.org/10.1001/jamapsychiatry.2018.1334NHS. (2021, December 10). Treatment- Psychosis: Treatment for psychosis involves a combination of antipsychotic medicines, talking therapies and social support. NHS choices. https://www.nhs.uk/mental-health/conditions/psychosis/treatment/#:~:text=Antipsychotics,transmits%20messages%20in%20the%20brain.

Schultze-Lutter, F., Kindler, J., Ambarini, T. K., & Michel, C. (2022). Positive psychotic symptoms in childhood and adolescence. Current Opinion in Psychology, 45, 101287. https://doi.org/10.1016/j.copsyc.2021.11.007

Stahl, S. M. (2018). Prescriber’s Guide, Children and Adolescents Stahl’s essential psychopharmacology. Cambridge University Press.

Stevens, J. R., Prince, J. B., Prager, L. M., & Stern, T. A. (2014). Psychotic disorders in children and adolescents: A primer on contemporary evaluation and management. Psychiatrist.com. https://www.psychiatrist.com/pcc/mental/child/psychotic-disorders-children-adolescents-primer-contemporary/

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â—„ Week 13 Assignment 1: iHuman Case Study

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Re: Week 13: Group-Facilitated Discussion 1 – Group 4

by Laura Joseph – Tuesday, 25 July 2023, 11:40 PM

Hi Group 4,Thank you for the valuable information and informative video shared in your post. Childhood vs. Adolescent Symptom Presentation & Treatment: Childhood and adolescence are distinct developmental periods with unique symptom presentations and treatment approaches to mental health. According to García-Carrión (2019), more than half of mental health problems start at these stages, and many persist throughout adulthood. In childhood, symptoms of mental disorders may manifest differently compared to adolescence. For example, children may have difficulty expressing their emotions verbally, so their symptoms may be displayed through behavior changes, such as irritability, difficulties in school, or frequent physical complaints (Schlack et al., 2023). In contrast, symptoms tend to be more similar during adolescence to those seen in adults. Adolescents may exhibit mood swings, risk-taking behavior, social withdrawal, and changes in sleep and appetite patterns (Schlack et al., 2023). These age groups can have a wide range of symptom presentations, and there is variability within and across different mental health disorders.Treatment for children and adolescents can include various approaches. In childhood, therapy often focuses on a systems-based approach involving parents, caregivers, and teachers. Play therapy may also be utilized to facilitate communication and emotional expression. Cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT) can be effective in adolescence (Caldwell et al., 2019). Medication may also be considered in both age groups, but it is typically used cautiously and in conjunction with therapy.Psychopharmacological vs. Complementary Treatment for Psychosis: The treatment of psychosis typically involves a combination of psychopharmacological and complementary interventions. Psychopharmacological treatment refers to using medications, primarily antipsychotic medications, to manage psychotic symptoms. These medications can help reduce hallucinations, delusions, and disorganized thinking (Plenty et al., 2021). Complementary treatments can be used alongside medication to support recovery. These may include cognitive-behavioral therapy for psychosis (CBTp), psychosocial interventions, family therapy, and supportive therapies like art therapy or music therapy. Complementary approaches aim to improve functioning, reduce distress, promote insight, and aid in developing coping strategies (Schlack et al., 2023).Screening Tools & Recommended Therapeutic Interventions: Screening tools can help identify potential mental health concerns and guide further assessment or intervention. Examples of screening tools commonly used in mental health include the Child Behavior Checklist (CBCL), Strengths and Difficulties Questionnaire (SDQ), and the Youth Self-Report (YSR) (Plenty et al., 2021). These assessments help identify many emotional and behavioral problems in children and adolescents.Recommended therapeutic interventions depend on the specific mental health concern and individual needs. Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and family therapy are commonly used and evidence-based approaches. Psychological interventions can help individuals develop coping skills, challenge unhelpful thoughts, manage emotions, and improve their overall well-being (Caldwell et al., 2019)Misdiagnosis of Childhood Psychotic Symptoms as Schizophrenia: Psychotic symptoms in childhood can sometimes be misdiagnosed as schizophrenia due to overlapping symptomatology (Schlack et al., 2021). To disentangle misdiagnoses, comprehensive assessments involving mental health professionals, neuropsychological testing, and collateral information from parents, caregivers, or teachers are critical. Establishing the duration, frequency, intensity, and context of psychotic symptoms is crucial in distinguishing between psychosis related to other disorders, such as trauma or mood disorders, and true childhood-onset schizophrenia (Schlack et al., 2023).References:Caldwell, D. M., Davies, S. R., Hetrick, S. E., Palmer, J. C., Caro, P., López-López, J. A., … & Welton, N. J. (2019). School-based interventions to prevent anxiety and depression in children and young people: a systematic review and network meta-analysis. The Lancet Psychiatry, 6(12), 1011-1020.García-Carrión, R., Villarejo-Carballido, B., & Villardón-Gallego, L. (2019). Children and Adolescents Mental Health: A Systematic Review of Interaction-Based Interventions in Schools and Communities. Frontiers in psychology, 10, 918. https://doi.org/10.3389/fpsyg.2019.00918Plenty, S., Magnusson, C., & LÃ¥ftman, S. B. (2021). Internalising and externalising problems during adolescence and the subsequent likelihood of being Not in Employment, Education or Training (NEET) among males and females: The mediating role of school performance. SSM – population health, 15, 100873. https://doi.org/10.1016/j.ssmph.2021.100873Schlack, R., Peerenboom, N., Neuperdt, L., Junker, S., & Beyer, A. K. (2021). The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. Journal of health monitoring, 6(4), 3–19. https://doi.org/10.25646/8863Schlack, R., Neuperdt, L., Junker, S., Eicher, S., Hölling, H., Thom, J., Ravens-Sieberer, U., & Beyer, A. K. (2023). Changes in mental health in the German child and adolescent population during the COVID-19 pandemic – Results of a rapid review. Journal of health monitoring, 8(Suppl 1), 2–72. https://doi.org/10.25646/10761

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Week 13: Group-Facilitated Discussion 1 – Group 4

To do:Make forum posts: 1

Value: 100 points

Due: Facilitating group to post by Day 1; all other students post to facilitating group discussion prompt by Day 4 and reply to at least two other peer posts by Day 7

Grading Category: Group Facilitated Discussions

Initial Post: Created by Facilitating Group

This is a student-led discussion.

• Please review the Week 7 Get Started: Group-Facilitated Communication Board and Instructions for assignment guidelines for this discussion to ensure that you have met all the criteria.
• The facilitating group should choose one member from their group who will be responsible for the initial post.
• On Day 1 of this week, the chosen group member will create an initial post that is to include the group’s discussion prompts, resources, and the instructions for what your classmates are to do with the resources.
• During this week, each member of your group is to participate in the facilitation of the discussion. This means making certain that everyone is engaged, questions from students are being answered, and the discussion is expanding.
• It is the expectation that the facilitating group will address all initial peer response posts by Day 7.

Reply Posts: Non-Facilitating Students

• If you are not a member of the facilitating group, you are to post a discussion prompt response according to the facilitating group’s instructions by Day 4. Your reply posts should include substantive reflection directed to the presenters.
• You are also expected to respond to at least two other peers’ initial discussion prompt posts.
• Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.

Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.

 

This is my Group’s post. I am the non facilitated group so I have to reply to a peer’s post

Re: Week 13: Group-Facilitated Discussion 1 – Group 4

by Meghan Bronkema – Monday, 24 July 2023, 2:36 AM

We are so close everyone! Welcome to Week 13!

Psychosis can appear during the developmental stages of adolescence and childhood, despite being frequently associated with adults. This presents special challenges and considerations for diagnosis, treatment, and long-term outcomes. To minimize its effects on a person’s overall well-being and prospects, early intervention and effective management of psychosis in this population are essential.

For reducing the long-term effects of psychosis and encouraging healthy futures, it is essential to recognize the special difficulties these demographic faces and to put early intervention techniques into place. We may work to support young people with psychosis in a more compassionate and efficient manner by promoting awareness, research, and access to specialist care.

For your original discussion post this week, please read the following articles in addition to the assigned readings this week, and craft an original post using one or more of the following prompts:

1. Compare and contrast childhood vs adolescent symptom presentation & treatment.2. Recommended psychopharmacological vs complementary treatment for psychosis.3. Discuss screening tools & recommended therapeutic interventions.4. Discuss how psychotic symptoms in childhood can be commonly misdiagnosed as schizophrenia and how to disentangle these.

Please reply to two separate peer posts on two separate days, using the following prompts:1. Propose several ways to support a child/adolescent and their caretakers at onset of illness. Please use two new resources.2. Discuss how stigma surrounding psychotic disorders can contribute to the child/adolescent patient with psychotic disorders and how we as PMHNPs can work in our practice to address this stigma.Recommended Readings:Bhatara, V. S., Daniel, J., Whitman, C., Vik, T., Bernstein, B., & Simkin, D. R. (2023). Complementary/Integrative medicine treatment and prevention of youth psychosis. Child and Adolescent Psychiatric Clinics of North America, 32(2), 273–296. https://doi.org/10.1016/j.chc.2022.08.009

Carroll D, Wales M, Rintell LS, et al. Burden experienced by primary caregivers of children with psychotic disorders and at clinical high risk for psychosis. Journal of the American Psychiatric Nurses Association. 2022;0(0). doi:10.1177/10783903221141883

Morales-Muñoz, I., Palmer, E. R., Marwaha, S., Mallikarjun, P. K., & Upthegrove, R. (2022). Persistent childhood and adolescent anxiety and risk for psychosis: A longitudinal birth cohort study. Biological Psychiatry, 92(4), 275–282. https://doi.org/10.1016/j.biopsych.2021.12.003

Schultze-Lutter, F., Kindler, J., Ambarini, T. K., & Michel, C. (2022). Positive psychotic symptoms in childhood and adolescence. Current Opinion in Psychology, 45, 101287. https://doi.org/10.1016/j.copsyc.2021.11.007

Stevens, J. R., Prince, J. B., Prager, L. M., & Stern, T. A. (2014). Psychotic disorders in children and adolescents: a primer on contemporary evaluation and management. The Primary Care Companion for CNS disorders, 16(2), PCC.13f01514. https://doi.org/10.4088/PCC.13f01514The following video will be useful as well:  

 

Re: Week 13: Group-Facilitated Discussion 1 – Group 4

by William Nichols – Monday, 24 July 2023, 7:40 PM

This post is from a peer that responded to our discussion post, I have to reply him for responding to us, I will give you a sample from a classmate

Introduction

            Hi group four, thank you for your insightful and knowledge-based post on psychotic disorders. One thing I learned while reading through this week’s course material that I found interesting was using another name for these types of disorders that do not seem so stigmatizing which is perceptual alteration disorders. This can be defined as conditions in which the individual experience a change in incoming stimuli and results in a diminished, exaggerated, distorted or impaired response to the stimuli ( Yearwood et al. 2012). In this post I will answer the questions including, compare and contrast childhood vs adolescent symptoms presentation and treatment, discuss psychopharmacological vs contemporary treatment for psychosis, discuss screening tools, and discuss how psychotic symptoms can be miss diagnosed as schizophrenia.

 

Compare and Contrast Adolescent Symptoms Presentation

            The presentation between of psychosis does not differ between the two age groups. In a case study discussed in AlHakeem et al. (2016) the child presented with disorganized speech, impaired motor function, visual and auditory hallucination, shorter attention span, and sleep disturbances. This patient discussed in the case study was three years old. I think where we can say they contrast is the level of cognitive distortions or speech can differ in that an adolescent can have more complex distortions due to having more life experiences, and improved language functioning. Sunshine et al. (2023) discusses that the rule in criteria for a psychotic disorder like schizophrenia are the same for all age groups in the DSM,

 

Psychopharmacological vs complementary and therapeutic treatment for psychosis

           Treatment for psychosis is the same for ages 12 years and older across the life span which includes psychotropic medications (Yearwood et al. 2012). According to Yearwood et al. (2012) is the time lapse between getting adequate treatment and the first psychotic episode. Psychosocial family interventions have also been shown to improve outcomes along with cognitive based therapy and psychoeducation for family (Yearwood et al. 2012), Examples of medications that can be considered are aripiprazole which has been approved by the FDA for schizophrenia in ages 13 and for mania ages 10 and older ( Stahl et al. 2020). There can be other antipsychotics that are not yet FDA approved, but research is going into treating children using psychopharmacotherapy due the importance of early treatment after the first psychotic episode. Clozapine has also been fount to improve symptoms in the pediatric and adolescent population, but due to this population being more sensitive to side effects, it is usually only used when other antipsychotics have failed. 

 

Screening Tools

          Screening tools include the early signs scale (ESS) and a assessment interview called the schedule for affective disorders and schizophrenia for school age children ( K-SADS). The K-SADS is used for children 6-18 and is unique in that it incorporates other people to get a larger picture of the client’s behaviors and background since psychotic disorders like schizophrenia are can have a genetic component. The ESS scale is a 36-question questionnaire that assess for prodromal symptoms of schizophrenia (Yearwood et al (2012).

 

How psychotic symptoms in childhood can be misdiagnosed with schizophrenia

            Psychotic symptoms can be misdiagnosed for schizophrenia because many people only relate psychosis with that disorder. People do not realize that physiological malignancies like encephalitis. In AlHakeem et al.(2016) they discuss a case of a 7 year old who had periorbital movement, new onset aggression and sleep disturbances and lost the ability to control urine and stool. Some may be worried a psychotic illness may be going on due to the behavioral changes, but further medical work up led to the encephalitis diagnosis. Examples like this show that we must consider physiological diagnosis and rile them out as well, and this solidifies the PMHNP need to have understanding of more than just psychiatric illnesses and understand physiological abnormalities.

 

References

AlHakeem, A. S., Mekki, M. S., AlShahwan, S. M., & Tabarki, B. M. (2016). Acute psychosis in children: do not miss immune-mediated causes. Neurosciences (Riyadh, Saudi abia), 21(3), 252–255. https://doi.org/10.17712/nsj.2016.3.20150760

 

Ellington, E. (2023). Clozapine Use in Early-Onset Schizophrenia. Journal of Psychosocial Nursing & Mental Health Services, 61(2), 6–8. https://doi.org/10.3928/02793695-20230109-02

Stahl, S. M., Stahl, S. M., & Stahl, S. M. (2018). Prescriber’s Guide, Children and Adolescents Stahl’s essential psychopharmacology. Cambridge University Press.

Sunshine, A., & McClellan, J. (2023). Practitioner Review: Psychosis in children and adolescents. Journal of Child Psychology & Psychiatry, 64(7), 980–988. https://doi.org/10.1111/jcpp.13777

Yearwood, E. L., Pearson, G. S., & Newland J. A. (2012). Child and adolescent behavioral health. Wiley-Blackwell. Chapter 11, Perceptual Alterations Disorders (pp. 204–216)  

 

 

This is a peer’s post that replied her peers from last week you can use it as a guide  

 

 

Re: Week 12: Group-Facilitated Discussion 1 – Group 3

by Whitney Poppell – Tuesday, 18 July 2023, 10:57 AM

Hi William! Thank you for your response to our group’s discussion prompt. You did a great job answering each of the prompt questions. I would like to expand on your response to the question regarding ACEs and how they are associated with a diagnosis of bipolar disorder. You found interesting information that stated that adverse childhood events can cause an earlier onset of bipolar disorder. It is true that ACEs have been associated with not only earlier onset of bipolar disorder, but also the development of more severe bipolar disorder symptoms (Park et al., 2020). As I researched this topic more, I found that ACEs are associated with structural and functional changes in the brain that lead to a higher likelihood of developing bipolar disorder, earlier onset of bipolar disorder, and more severe bipolar disorder. ACEs have been shown to be associated with changes in white matter in the brain, which can lead to more severe bipolar disorder (Benedetti et al., 2014). ACEs can cause disruptions in structural connectivity in the developing brain of children or adolescents and lead to the development of bipolar disorder (Benedetti et al., 2014). ACEs are also thought to cause an interaction with vulnerable genes during childhood that can lead to an earlier onset of bipolar disorder (Park et al., 2020).ReferencesBenedetti, F., Bollettini, I., Radaelli, D., Poletti, S., Locatelli, C., Falini, A., Smeraldi, E., & Colombo, C. (2014). Adverse childhood experiences influence white matter microstructure in patients with bipolar disorder. Psychological Medicine, 44(14), 3069-3082. https://doi.org/10.1017/S0033291714000506Park, Y.M., Shekhtman, T., & Kelsoe, J.R. (2020). Interaction between adverse childhood experiences and polygenic risk in patients with bipolar disorder. Translational Psychiatry, 10(326). https://doi.org/10.1038/s41398-020-01010-1