Adolescent Psychosis: Clinical and Scientific Perspectives

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Adolescent Psychosis: Clinical and Scientific Perspectives
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About the contributors
	Chapter 1 Introduction to psychotic disorders in adolescence
	Chapter 2 The epidemiology of early-onset psychosis
	Chapter 3 Genetics of psychotic disorders with focus on early-onset psychosis
	Chapter 4 Early risk factors in early-onset psychosis
	Chapter 5 Adolescent psychosis and transdiagnostic delimitations to other clinical syndromes
	Chapter 6 Cognitive functioning in early-onset psychosis
	Chapter 7 The immunopsychiatry of early-onset psychosis
	Chapter 8 Structural brain imaging in early-onset psychosis
	Chapter 9 Functional brain imaging in early-onset psychosis
	Chapter 10 Adolescence as a vulnerable period for psychosis development
	Chapter 11 Current treatment options in early-onset psychosis
	Chapter 12 Long-term development and outcome of early-onset psychosis
	Chapter 13 Ethical considerations and current research practices in adolescent psychosis
1. Introduction to psychotic disorders in adolescence
	Introduction
	Clinical characteristics
		Psychotic experiences
		Symptom domains
			Positive symptoms
			Negative symptoms
			Disorganized symptoms
			Affective symptoms
		Suicidal behavior
	Diagnostic interviews
		Schedule for affective disorders and schizophrenia for school-age children-present and Lifetime version (K-SADS-PL)
		Structured clinical interview for DSM (SCID)
		Mini-International Neuropsychiatric Interview (M.I.N.I.)
	Comorbidity
		Psychiatric comorbidity
		Somatic comorbidity
	The neurodevelopmental hypothesis of schizophrenia
	Genetic and environmental influence
	Clinical heterogeneity
	Future directions
		Developmental trajectories
		Interdisciplinary studies
		Experimental approaches
		Clinical and societal responsibility
		Ethical considerations
	Conclusion
	Acknowledgments
	References
2. The epidemiology of early-onset psychosis
	Introduction
	The incidence and prevalence of adolescent psychosis
		Population-based epidemiological studies
		Studies from the Global South
		Affective psychotic disorders
		Sex differences
		Diagnostic stability
	Incidence and prevalence of psychotic symptoms in adolescence
	Methodological considerations
	Future directions
	Conclusions
	References
3. Genetics of psychotic disorders with focus on early-onset psychosis
	Introduction
	Genetic epidemiology
		Family studies
		Twin and adoption studies
	Molecular genetics
	Methods
		Linkage studies
		Candidate gene studies
		Genome-wide association studies
		Novel polygenic analytical approaches
			Polygenic risk score (PRS)
			Heritability estimations
			Enrichment analysis
		Copy number variants
		Whole exome/genome sequencing
		Pharmacogenetics and pharmacogenomics
	Genetic architecture of early-onset psychosis
		Common variants
		Rare variants
		Copy number variants in psychotic disorders
		Imprinting disorders, epigenetics, and psychosis
		Genetic overlap
	From genetic loci to disease mechanisms
	Clinical implications
	Conclusion
	Acknowledgments
	References
4. Early risk factors in early-onset psychosis
	Biological risk factors
		Pre- and perinatal factors
			Hypoxia
			Infections
			Nutrients
		Cannabis use
		Hormonal changes
	Psychological risk factors
		Clinical high-risk
		Early childhood adversity
			Emotion regulation
			Hypothalamic-pituitary-adrenal (HPA) axis
			Dopamine
	Social risk factors
		Social stress
		Immigrant, racial and ethnic minority status
	Conclusions
	Clinical implications
	Future directions
	Acknowledgment
	References
5. Adolescent psychosis and transdiagnostic delimitations to other clinical syndromes
	Introduction
	Prenatal and young life predictors of early-onset psychosis
	ESSENCE
		ESSENCE as a concept
		Prevalence of ESSENCE
			Attention-deficit/hyperactivity disorder
			Autism spectrum disorder
			Speech and language disorder
			Developmental coordination disorder
			Intellectual developmental disorder and borderline intellectual functioning
			Tourette\'s disorder and other tic syndromes
			Reactive attachment disorder and disinhibited social engagement disorder
			Pediatric acute-onset neuropsychiatric disorder (PANS/PANDAS)
			Behavioral phenotype syndromes and neurological disorders
			Substance-induced psychosis
	When should one suspect an ESSENCE disorder?
	Outcome of ESSENCE
	How to deal with ESSENCE specifically in the context of early-onset psychosis
	Implications of further intervention/treatment approaches
	Future directions
	References
6. Cognitive functioning in early-onset psychosis
	Introduction
	Relevant cognitive domains
		Processing speed
		Learning and memory
		Working memory
		Attention
		Executive functions
		Social cognition
		Intelligence quotient (IQ)
	The neurobiology of cognition
	Cognitive course
	Sex differences in cognitive functioning
	Cognition and symptoms
	Cognition and functional outcome
	Cognitive assessment
		The Wechsler Intelligence Scales for children and adults
		The MATRICS Consensus Cognitive Battery
		Other cognitive batteries for schizophrenia
	Clinical implications
		Pharmacological treatment
		Cognitive remediation
		Psychoeducation
	Future directions
	Conclusion
	Acknowledgments
	References
7. The immunopsychiatry of early-onset psychosis
	Introduction
	The immune system and neurodevelopment
		Immune system functions and brain physiology
		Cytokines in CNS development, maintenance, and pathophysiology
		Glial cells in CNS development, maintenance, and pathophysiology
		Cytokines and glial cells in adults with psychotic disorders
		The neurodevelopmental aspects of immune activation in psychosis
	Clinical findings on immune system dysregulation in individuals with psychotic disorders
		Immune-inflammatory markers in longitudinal studies of psychosis
		Predictive value of immune-inflammatory markers in individuals with clinical high risk for psychosis
		Immune-inflammatory markers in adolescents with early-onset psychosis
		Relationships between immune-inflammatory markers and clinical phenotypes in individuals with early-onset psychosis
	Scientific implications
	Clinical implications
	References
8. Structural brain imaging in early-onset psychosis
	Introduction
	Structural MRI methods
		Subcortical and cortical morphometry
		White matter microstructure and connectivity
	Subcortical brain morphology
		Intracranial-, subcortical, and cerebellar structure volumes
		Subcortical structures in bipolar disorder
	Cortical brain morphology
		Altered cortical structures and development
		Cortical structures in bipolar disorder
	White matter microstructure and connectivity
		White matter microstructure and connectivity in psychosis
		White matter microstructure and connectivity in early-onset psychosis
		White matter microstructure and connectivity in bipolar disorder
	Relationships with symptom profiles and functioning
	Impact of medication
	Clinical implications
	Future directions
	Conclusion
	References
9. Functional brain imaging in early-onset psychosis
	Introduction
	Systematic literature review
	Task-related functional magnetic resonance imaging studies
		Cognitive systems
			Cognitive control: response selection, inhibition/suppression, performance monitoring
			Cognitive control: updating, representation, and maintenance
			Declarative memory
			Working memory
		Social processes
			Social communication: reception of facial communication
		Positive valence systems
			Reward learning: probabilistic and reinforcement learning
			Reward responsiveness
		Sensorimotor systems: motor actions
		Arousal and regulatory systems: arousal
		Summary of t-fMRI findings
	Resting-state functional magnetic resonance imaging studies
		Resting-state connectome architecture and topology
		MR regional homogeneity and amplitude
		Resting-state networks
		Seed-based resting-state connectivity
			Amygdala
			Thalamus
			Cerebellum
			Prefrontal regions
		Interhemispheric connectivity
		Summary of rs-fMRI findings
	Conclusions and future directions
	References
10. Adolescence as a vulnerable period for psychosis development
	Introduction
		Social behavior during adolescence
		Social interactions can be rewarding and stressful
		Hypothalamus–pituitary–adrenal axis
		Hypothalamus–pituitary–gonadal axis
		Interactions between the HPA and HPG axes
	White matter during adolescence
	Cerebral cortex during adolescence
		Virtual histology
	Brain response to faces: organizational and activational effects of testosterone
	Conclusions and future directions
	References
11. Current treatment options in early-onset psychosis
	Introduction
	General treatment principles
	Antipsychotic treatment
		Choice of medication
		Side effects
			Neuromotor
			Metabolic
			Cardiac
			Endocrine
			Autonomic
			Sedative
			Side effect monitoring
		Genetic variation
		Approved medications
		Switching medication
		Discontinuing medication
		Antipsychotic medication and pregnancy
		Pharmacological treatment of other psychiatric symptoms
		Electroconvulsive therapy
	Psychosocial treatment
		Early Intervention Services
			OPUS YOUNG
				Cognitive-behavioral case management
				Psychoeducational family-based intervention
				Social cognition and interaction training
				Cognitive-behavioral therapy
				Prevention and treatment of substance abuse
				Support to siblings
				Support from peers
				Transition to adult psychiatry or social services
		Cognitive remediation therapy
	Future directions
	Conclusions
	Acknowledgments
	References
12. Long-term development and outcome of early-onset psychosis
	Introduction
	Sociodemographics
		Labor market affiliation, education, and income
		Children and cohabitation
	Service use
	Substance abuse
	Mortality and suicidality
	Medication
	Cognition
	Long-term prognosis
		Clinical predictors of outcomes
		Positive and negative symptoms
		Recovery
	Conclusion
	Acknowledgments
	References
13. Ethical considerations and current research practices in adolescent psychosis
	Introduction
	Ethical considerations in adolescent psychosis research
		Early diagnosis and treatment
		Genetic information
		Brain maturation and its impact on cognitive and social skills development
		Informed consent
			Gray area in terms of informed consent
		Stigma and self-stigma related to the diagnosis
	Practical considerations in adolescent psychosis research
		Communication
			Focus groups
			Representativity
		Length of the research protocol, and adherence to longitudinal studies
		Interview format
		Data collection and sharing
			Deidentification
		Incidental findings
	Future directions and conclusion
	Acknowledgments
	References
Index
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