Recognition and management of psychosis and schizophrenia in children and young people: summary of NICE guidance

Psychosis, including schizophrenia, comprises a major group of psychiatric disorders characterised by hallucinations and/or delusions (psychotic symptoms) that alter perception, thoughts, affect, and behaviour, and which can considerably impair a child or young person’s development, relationships, and physical health. Schizophrenia is estimated to affect 1.6 to 1.9 per 100 000 in the child population,1 2 with prevalence increasing rapidly from age 14.3 Psychosis and schizophrenia in children (age 12 years and under) and young people (up to age 17 years) are leading causes of disability4 and are more severe and have worse prognosis than if onset is in adulthood, owing to disruption to social and cognitive development. Young people with schizophrenia tend to have a shorter life expectancy than the general population, largely because of suicide, injury, or cardiovascular disease,5 the last partly from antipsychotic medication. Children and young people with transient or attenuated psychotic symptoms are at increased risk of developing psychosis or schizophrenia,6 and delayed treatment can impair longer term outcomes,7 making early recognition and intervention crucial.

This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) guideline on psychosis and schizophrenia in children and young people.8