Polish Psychiatric Association diagnostic and therapeutic management guidelines for patients with early-onset schizophrenia
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Śląski Uniwersytet Medyczny w Katowicach, Katedra i Oddział Kliniczny Psychiatrii i Psychoterapii Wieku Rozwojowego, Centrum Pediatrii w Sosnowcu
Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
Instytut Psychiatrii i Neurologii w Warszawie, Klinika Psychiatrii Sądowej
Instytut Psychiatrii i Neurologii w Warszawie, Klinika Psychiatrii Dzieci i Młodzieży
Pomorski Uniwersytet Medyczny w Szczecinie, Katedra i Klinika Psychiatrii
Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, Klinika Psychiatrii Dzieci i Młodzieży
Instytut Psychiatrii i Neurologii w Warszawie, III Klinika Psychiatryczna
Submission date: 2022-03-26
Final revision date: 2022-04-02
Acceptance date: 2022-05-03
Online publication date: 2022-08-31
Publication date: 2022-08-31
Corresponding author
Adam Wichniak   

Instytut Psychiatrii i Neurologii
Psychiatr Pol 2022;56(4):675-695
Early onset of schizophrenia (before the age of 18 years) is associated with a higher risk of delayed or missed diagnosis, more severe course of the disease, and an increased susceptibility to adverse reactions to antipsychotic drugs. The objective of this paper is to present the recommendations for the diagnostic and therapeutic management of patients with early-onset schizophrenia, developed on the basis of a literature review and a consensus of a group of experts working with schizophrenia therapy. The formal criteria that must be met to diagnose schizophrenia are the same for children and adults. Early-onset schizophrenia must be thoroughly differentiated from uni – or bipolar affective disorder, autism-spectrum disorders (ASDs) and anxiety disorder. Diagnostic assessment for psychotic disorders is also necessary in the case of abnormal, destructive or aggressive behaviour, or self-harm. The mainstay of schizophrenia treatment is pharmacological therapy, which is used in the treatment of acute episodes and in maintenance treatment – prevention of relapses. However, the use of pharmacological interventions in children and adolescents only to reduce the risk of psychosis development is not justified. Antipsychotic agents significantly differ by their tolerance profile and clinical efficacy. Second-generation antipsychotic agents approved for the treatment of early-onset schizophrenia – aripiprazole, lurasidone and paliperidone – enable its effective and safe treatment. The necessary complement to pharmacological therapy is non-pharmacological interventions that should be adapted to the patient’s age, cognitive abilities, disease stage and the needs of the whole family.
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