Diagnostic assessments In general, the psychiatric assessment of psychosis in children follows the model for comprehensive psychiatric assessment of children and adolescents, which includes a medical and psychiatric history, mental status examination, physical examination, and standardized psychiatric assessment instruments. The psychiatric history focusing on psychotic symptoms must carefully delineate family history, course of illness, and comprehensive review of symptoms. Particularly, the extent, nuance, and context of the psychotic phenomena must be clarified to identify mood Inhibitors,research,lifescience,medical congruence, mood incongruence, bizarre content, and stability of symptoms.
Most importantly, psychosis must be ruled out when the phenomenology does not hold under close diagnostic scrutiny. While no medical assessment procedure is diagnostic of COS or any other psychiatric condition associated with psychosis, use of imaging Inhibitors,research,lifescience,medical studies, electroencephalography, and laboratory tests may help detect medical conditions associated with psychosis in children and adolescents. Screening instruments Before a Inhibitors,research,lifescience,medical formal diagnosis is established, and in addition to using a reliable and valid structured or semistructured interview, screening instruments may help identify psychiatric Pifithrin-�� solubility dmso disorders associated with psychotic symptoms. Screening instruments for depression in children and adolescents
Inhibitors,research,lifescience,medical include the Children’s Depression Inventory,52 which has normative data for children and adolescents. The Young Mania Rating Scale (Y-MRS)53 has normative data for adolescents with BPAD. There is no screen with normative data for children with schizophrenia or other psychotic disorders. Semistructured diagnostic interviews The stringent use of adult criteria to delineate psychotic
symptoms in children and adolescents, and the development of reliable and Inhibitors,research,lifescience,medical valid rating instruments to clarify the presence and severity of these symptoms suggest that some children with psychotic illness are exhibiting an early manifestation of the adult form of the illness. Homogeneous diagnostic criteria have demonstrated that COS can be diagnosed using adult standards,54,55 and studies using DSM-III and DSM-III-R criteria confirmed these findings.9,56 Rigorous application of DSM-III criteria can accurately diagnose childhood BPAD.57 Standardized interviews, such as the Schedule found for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (K-S ADS-PL),58 the Diagnostic Interview for Children and Adolescents (DICA),59 and the Diagnostic Interview Schedule for Children (DISC)60 are reliable and valid measures for diagnosing MDD, BPAD, COS, and other psychiatricdisorders in childhood that present with psychosis. The K-SADS is the probably the gold standard.