By Nitin Gogtay, MD, April 18, 2019
Neuropsychiatry, Child Adolescent Psychiatry, Schizophrenia
Although psychotic illnesses are fortunately rare in children, contrary to common belief, psychotic symptoms can be fairly common in very young healthy children. As a symptomatic child grows older, these experiences tend to become much less frequent but, if symptoms persist, they can be indicators of increased risk for more serious mental illness and poorer outcomes later in life.
Given the reasonably common occurrence of hallucinations in otherwise healthy children it is critically important that the symptoms be carefully characterized and a diagnosis such as schizophrenia be made with extreme caution in children. For example, an “imaginary friend,” or hallucinations while transitioning either into asleep (hypnogogic) or wakefulness (hypnopompic) are common and should not be considered problematic in healthy children. The important challenge comes when hallucinations or other psychotic experiences are more pervasive, serious, and pose a diagnostic and treatment challenge.
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