Psychosis In Children Essay

Psychotic disorders in children are not common, however it is generally agreed that its prevalence increases during adolescence. The prevalence of psychosis in 13 to 19-year-olds was reported to be 0.54%, increasing from 0.9 per 10 000 at age 13 years to 17.6 per 10 000 at 18 years.8

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Psychotic disorders in adolescence can pose not only diagnostic and treatment challenges, but also difficulties to the adolescent as well as their families. As can be seen in MLS’s case, there were challenges since the initial onset of symptoms including diagnostic uncertainties, difficulties faced by MLS and his parents due to the uncertainty in diagnosis which then led to worsening of symptoms and a rehospitalisation. In addition, the onset of symptoms at the age of 17 would be of significance for MLS as this is the age where several important life events would take place such as the major school examinations Sijil Pelajaran Malaysia, which may determine his academic and occupational future, in addition to other important life transitions such as having a relationship with the opposite sex, completing school and making a decision regarding the next step in his life such as whether or not to pursue further education. As such, accurate and early diagnosis, with appropriate treatment is of utmost importance to ensure achievement of remission and to minimize any disabilities.Psychosis In Children Essay

Though schizophrenia in prepubertal children is rare, the prevalence of schizophrenia in adolescents is approximately 1 to 2 per 1,000, with an estimated ratio of 1.67 boys to 1 girl. The rate of onset is reported to increase during adolescence, and while the onset of illness is usually insidious, it may occur suddenly in a previously well child, such as in MLS’s case. Multiple aetiological factors contribute to the development of schizophrenia, including genetic, neurodevelopmental, as well as environmental risk factors.11 There is a family history of psychiatric illness among 2 of MLS’s paternal relatives and although their diagnoses could not be ascertained, it is likely that his paternal uncle had suffered from a psychotic illness in the past from the description given. This contributes to genetic loading which poses as a risk factor for the development of MLS’s illness.

Another significant finding is that child and adolescent-onset schizophrenia is associated with premorbid developmental and social impairments. Some children and adolescents with schizophrenia are premorbidly more likely to have lower intelligence quotient, social withdrawal, isolation, poor peer relationships, excessive anxiety and academic trouble as compared to adult-onset schizophrenia, while some others may have histories of delayed motor or language milestones similar to some symptoms of autistic disorder. 12,13 A study on child and adolescent-onset psychoses found significant difficulties in social development affecting ability to make and keep friends in a third of cases with schizophrenia.14 MLS had poor eye contact as a child and although he did not have any other features of autism, he appears to be more socially reserved, having only few friends. This puts him at risk of developing schizophrenia, however whether premorbid impairments pose as a risk or precursor of psychosis remains a question. These premorbid impairments may be a causative factor for psychosis, or on the other hand, could be markers of an underlying neuropathological process which may be the cause of both the premorbid social impairment and psychosis.Psychosis In Children Essay

In addition, MLS had reported seeing shadows on a few occasions during childhood, at age 10 and 12 years old. An association between self-reported psychotic symptoms during childhood and later schizophrenia has been found.4 A 15-year longitudinal cohort study demonstrated a very high risk of schizophreniform disorder at age 26 among individuals who reported psychotic symptoms at the age of 11 with an odds ratio of 16. 42% of the schizophreniform cases at age 26 reported one or more psychotic symptoms at age 11 years, including hallucinatory experiences and delusional beliefs. The individuals who reported the psychotic symptoms at age 11 did not have mania or depression at age 26, suggesting specificity of prediction to schizophreniform disorder.15 Though this study found an association between psychotic symptoms in childhood and later schizophreniform disorder but not schizophrenia, it appeared that attenuated psychotic symptoms contribute a significant high-risk premorbid phenotype.4

Growing up, MLS’s parents executed different parenting styles towards him. While his father gave him freedom and did not seem very involved in his daily living, his mother was overinvolved and controlling of his activities. The different types of parenting were described by Diana Baumrind in 1966 who introduced three models of parental control, namely authoritarian, authoritative and permissive. In permissive parenting, the parent is non-punitive and acceptant towards the child’s actions and desires, makes few demands for responsibility, allows the child to regulate his own activities and avoids the exercise of control.16 The parent imposes few maturity demands and either indulges or neglects the child’s needs.17 On the other hand, authoritarian parenting is characterized by high expectations of conformity to parental rules. The parent is obedience-oriented and the child is expected to obey orders without explanation. According to Baumrind, both permissive and authoritarian type of parenting may prevent the child from being able to engage in interaction with people. Children and adolescents of authoritarian parents are tend to have less self-confidence and become socially withdraw, while permissive parents tend to suffer from problems with emotional regulation and self-control, and thus they were reported to be more likely involved in problematic behaviours and aggression.18 In MLS’s case, as MLS’s mother plays a more dominant role in the family compared to his father, her authoritarian parenting had resulted in MLS becoming more socially withdrawn, mostly staying at home with few friends. More importantly, this had resulted in a lack of bonding between MLS’s mother and himself.Psychosis In Children Essay

MLS had started to develop symptoms of unusual behaviour 3 days after being discharged from Klang Hospital for dengue fever, in addition to being socially withdrawn and deterioration in functioning. Though MLS seemed preoccupied when admitted to University Malaya Medical Centre the first time, he was unable to describe any positive symptoms of psychosis until the second admission when he had developed auditory hallucinations, persecutory delusion and thought echo. It has been reported that children and adolescents with psychosis can typically present with a prodromal period characterized by deterioration in personal functioning and negative symptoms such as concentration and memory problems, unusual behaviour, bizarre perceptual experiences, social withdrawal, apathy and reduced interest in daily activities, some of which are observed in MLS’s case. These symptoms may follow an acute period of stress or a physical illness, which was dengue fever in MLS’s case.19 Frank psychosis develops within 12 months of symptom onset in 40% of patients20, and this prolonged duration of prodromal period may affect school performance as well as delay the diagnosis of psychosis or schizophrenia, but for MLS the psychotic symptoms developed much earlier.Psychosis In Children Essay

The acute episode which follows the prodromal period is usually characterize by positive symptoms of hallucinations and delusions, which may lead to a sense of fear of puzzlement during the period of delusional mood. As perceptual disturbances may be new experiences for children or adolescent, they may be distressed or confused, as can be observed in MLS who appeared confused and preoccupied, and may subsequently develop secondary delusional belief such as being replaced with doubles when they experience themselves or family members as being unfamiliar. As for MLS, the lumbar puncture performed on him in the neuromedical ward may have strengthened the persecutory delusion where he started to believe that someone intentionally removed a bone from his spine and further persecutory delusion such as the belief that people wanted to poison his food in the ward.Psychosis In Children Essay

A detailed assessment including thorough history and physical examination as well as diagnostic workups need to be performed as psychosis in childhood and adolescence may result from an organic cause such as infection as well as neurological, autoimmune, endocrine or metabolic conditions. Neuropsychiatric conditions such as encephalitis, temporal lobe epilepsy, cerebral lupus, drug intoxication as well as neurodegenerative illnesses such as Wilson’s disease need to be ruled out particularly when there are neurological signs or fluctuating levels of consciousness, in which blood tests, computed tomography (CT) scan, MRI or electroencephalography (EEG) may be helpful.19 As for MLS, organic workup was performed during both the admissions to UMMC due to the acute onset of abnormal behaviour and presentation after dengue fever during the first admission, as well as an episode of recorded fever and confusion during the second admission.Psychosis In Children Essay

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MLS was investigated for post-dengue encephalitis during the first admission to UMMC. Dengue viral infection can present with varying clinical manifestations ranging from asymptomatic infection to life threatening haemorrhagic fever and dengue shock syndrome. Apart from the cmp renal and hepatic dysfunction, dengue fever can present with neurological complications including dengue encephalopathy, encephalitis, neuromuscular complications as well as neuro-ophthalmic involvement in 4-5% of confirmed dengue cases.21 While the more common symptoms of encephalitis include headache, disorientation and seizures, neuropsychiatric symptoms such as psychosis, mania and dementia have been reported as post-infectious sequelae.22 A case report in 2013 described a 12-year old boy who presented with behavioural change characterized by emotional lability, dependence, alteration in rhythm of language and tone voice, anxiety and change in tastes in addition to fever, severe headache, seizures and vomiting. Though magnetic resonance and computed tomography showed no brain changes, serology for dengue was positive for both IgM and IgG and cerebrospinal fluid revealed high protein levels and increased lymphocytes. The boy had improved with risperidone, but behavioural symptoms were still reported to be present 60 days later. 23 Another author reported a 21-year old man who developed an episode of classical manic symptoms including overactivity, excessive talking, argumentativeness, irritability, grandiosity, abusiveness and decreased need for sleep on the 6th day of dengue illness with thrombocytopenia, and was successfully treated with carbamazepine and haloperidol.24 The diagnosis of dengue encephalitis may be made either by detection of virus or antibodies in the cerebrospinal fluid, but the absence of antibodies will not rule out encephalitis. MRI, the modality of choice of brain imaging, may show findings consistent with viral encephalitis such as cerebral oedema, white matter changes, brain atrophy and necrosis.25 In MLS’s case, there was no evidence suggestive of infection in his blood or cerebrospinal fluid tests, while blood imaging and electroencephalography did not reveal any significant findings. This points against the diagnosis of post-dengue encephalitis, although the investigations done by the neuromedical team during both admissions were justified and thorough.Psychosis In Children Essay

The management of adolescent psychotic disorder encompasses many aspects and should take into consideration a risk assessment to self and others, mental state, insight into illness, likely adherence to treatment as well as level of support available, in addition to any predisposing, precipitating, maintaining and protective factors. As children and adolescents with psychosis or schizophrenia and their families may experience significant distress, it is important to engage both the young person and their parents or carers in the management of their illness, which is the foundation of subsequent pharmacological and psychosocial interventions. The Early Pyschosis Declaration emphasizes the reduction of long delays that families face by services working better together and earlier to meet needs of young people and their parents. Among the issues that need to be considered in the management of children and adolescents with psychotic disorder include the normal developmental tasks of adolescents, effectiveness and safety of particular treatments as well as offering service and information to parents about costs and benefits of any recommended treatment. Psychoeducation for the young person and their families is important, such as in MLS’s case as his parents have limited awareness of mental illness and had missed MLS’s initial psychiatric appointment as they thought that he was well when he was still preoccupied and had started to develop positive psychotic symptoms. Explanation about the illness, guidance as well as involving family members in treatment decisions are important in ensuring compliance and continuity of care particularly as the young person such as MLS transits from adolescence to early adulthood.Psychosis In Children Essay

Though it is recommended that psychosocial and other benign options should be employed before considering medication, pharmacological treatment such as antipsychotics has been more widely used in recent times. Though there are few benefits of second generation antipsychotics over first generation antipsychotics in efficacy in treating early-onset schizophrenia and schizoaffective disorder, the former is less likely to cause side effects of extrapyramidal symptoms but at the same time are associated with weight gain, metabolic problems and risk of diabetes, as part of the findings from the treatment of early-onset schizophrenia spectrum disorders study (TEOSS).26 As such, it has been recommended that lifestyle and dietary advise should be given in addition to side effect monitoring when initiating an antipsychotic medication.27

Though antipsychotic medication is effective in reducing positive psychotic symptoms, with a modest effect size of 0.2 to 0.3, there is limited evidence for antipsychotic treatment of psychosis and schizophrenia in young people, with only minimal differences in efficacy found among the different antipsychotics but with large differences in side effect profiles.28 A Cochrane review of antipsychotic medication used in children below age 13 years with childhood-onset schizophrenia found inconclusive evidence regarding the effects of antipsychotic medication for early-onset schizophrenia, with clozapine showing benefits over haloperidol in treatment resistant schizophrenia but were offset by risk of serious adverse effects.29 Another meta-analysis on the efficacy, safety and tolerability of antipsychotics in adolescents aged 13 to 17 years with schizophrenia demonstrated that antipsychotic treatment with risperidone, olanzapine or aripiprazole resulted in significant improvement in symptomatology, and that treatment with 10mg daily dose of aripiprazole was associated with the lowest incidence of extrapyramidal symptoms with no significant weight gain.30 However, most antipsychotic medications have not been approved to treat early-onset schizophrenia as they have not been tested in the younger individuals. In Europe, aripiprazole and more recently paliperidone which was approved the use in adolescent schizophrenia, while aripiprazole, olanzapine, paliperidone, risperidone and quetiapine are approved by the Food and Drug Administration (FDA) in the United States for the treatment of early-onset schizophrenia in individuals aged 13 to 17 years old.31 Antipsychotic treatment was started for MLS due to the severity of the psychotic symptoms as well as the risk of harm to self and others. As he had developed side effects of sedation with a low dose of risperidone, it was changed to aripiprazole, which was then switched to olanzapine when he did not respond to aripiprazole at a dose of 10mg daily. His symptoms improved with olanzapine and had maintained well with this medication, but he would need to be regularly monitored for weight gain and metabolic side effects. As he had started to experience weight gain, dietary advice was given and continuation of active lifestyle and exercise which he was beginning to engage in was encouraged.Psychosis In Children Essay

Psychological interventions such as cognitive behavioural therapy have been studied and found that cognitive behavioural therapy can be possibly used to reduce the strength of delusional beliefs as well as to reduce the likelihood of relapse among young individuals with first episode of psychosis. In addition cognitive remediation therapy, art therapy as well as structured employment approaches are being developed and evaluated.19 Family intervention adapted for the developmental needs of adolescents aiming to reduce criticism and hostility towards the adolescent may also be helpful.31 In MLS’s case, a lesser overinvolvement by his mother was encouraged as overprotection and emotional overinvolvement are associated with high expressed emotion, which are in turn associated with a high relapse rate among patients with schizophrenia.Psychosis In Children Essay

More importantly for MLS is the return of functioning and continuation of schooling as this is his final year of secondary education and also the year in which he is bound to sit for the Sijil Pelajaran Malaysia examinations. It may be a stressful situation for MLS going back to school after a duration of 2 months of not attending school, in addition to the stress of catching up with studies, preparing for exams as well as possible stigma from others in school. It is important for school staff to support young individuals with psychosis or schizophrenia in school as they may feel distressed by their psychotic symptoms which may be worsened by responses of those around them, particularly if they get mocked or bullied by others. In addition, exposure to environments or classes with high levels of expressed emotion should be minimised as they are known to increase the risk of relapse but at the same time provide opportunities for social interaction with others.Psychosis In Children Essay

As there is a risk of future relapse with ongoing stressors such as sitting for examinations, expanding academic and career capabilities as well as undergoing the transition from adolescence to adulthood, ongoing follow-up is recommended for MLS. Among the factors contributing to a poorer prognosis in child and adolescent-onset psychosis include premorbid social and cognitive impairments, prolonged first psychotic episode, prolonged duration of untreated psychosis and negative symptoms. Schizophrenia in young individuals typically run a chronic course, with only 12% found to be in full remission at discharge and those with full recovery most likely recover within first 3 months of onset of psychosis.19 Nevertheless young individuals who do not undergo complete recovery from the illness may still be able to maintain an acceptable quality of life with adequate support as recovery is a personal process involving finding a sense of self and hope. As for MLS, regular follow-up and assessment of treatment needs in addition to return to functioning, prevention of a future relapse as well as continuous support from family members are crucial to ensure a good quality of life as an adolescent and a smooth transition to adulthood.Psychosis In Children Essay

Delusions and hallucinations are the most commonly known symptoms of schizophrenia. Most people have a basic idea of what schizophrenia is but few people look into early onset, or childhood, schizophrenia. Childhood schizophrenia is rare; only 1 in 100 people living with this disorder developed it during their childhood years. This mental disorder is defined as a rare and severe form of the known psychotic disorder, schizophrenia, which starts in children who are younger than thirteen and most often older than seven. It is essentially the same as adult schizophrenia; however it is harder to diagnosis in children (American Psychiatric Association, 2013). Despite its rarity, research has provided information on the symptoms and diagnosis, the treatments, and the possible causes behind this mental disorder.Psychosis In Children Essay
Much like adulthood schizophrenia, the diagnostic criteria includes the presence of delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and other negative symptoms such as low emotional expression. For a diagnosis in the DSM-5, two of the symptoms listed above must be present for a great deal of time during a one month period, and at least one of the symptoms must include either delusions, hallucinations, or disorganized speech (American Psychiatric Association, 2013). While this is the basic criteria for diagnosing schizophrenia of a patient of any age, there are some differences in how children may show symptoms and how these symptoms should be used to provide a diagnosis. First of all, delusions and hallucinations can be less elaborate than those of adults. Visual hallucinations are the most common symptom for children, but it can often be mistaken for a child’s imagination.Psychosis In Children Essay

Schizophrenia is a mental illness which affects millions of people throughout the world. Scientists have begun to understand more and more about the possible causes, predisposing factors, types, and possible treatments for schizophrenia. (Torrey, 1995) It is very rare for schizophrenic symptoms to appear before the age of 12 but it does occur. Recently, there has been a growing interest in childhood schizophrenia. It is less than one-sixtieth as common as the adult-onset type but the characteristics are very similar. Childhood schizophrenia also tends to be harder to treat and to have a worse prognosis than the adult-onset form. (Rapoport, 1997)Psychosis In Children Essay

Delusions and hallucinations are the most common symptoms of schizophrenia. Most people understand the basic concept of schizophrenia, but few are worried about schizophrenia schizophrenia. Childhood schizophrenia is rare and in childhood only 1 percent of people suffer from this disease. This mental disorder is known as a mental disorder that is known to be rare and severe schizophrenia that develops in children under 13 years old, usually 7 years and older.

• NICE guidelines on current drug treatment for children and adolescents with psychiatric disorders and schizophrenia, bipolar disorder for children and adolescents, NICE quality standards for psychiatric disorders and schizophrenia, NICE guidelines for adult psychosis and schizophrenia; adults Psychosis and schizophrenia NICE quality standards and other relevant NICE guidelines Once labor needs are assessed, it is necessary to consider the impact of service reconfiguration, recruitment, and personnel development along with the provider. This should include checking that the provider gathers the result measurements specified in section 4.4 and has a plan to periodically use it. In order to ensure the necessary changes, it is necessary to establish a task and complete the design team and implementation team. The commissioner is:Psychosis In Children Essay

Appendix 2 – Basic Components of NICE Approval Care Package This appendix provides information on NICE guidelines for childhood and adolescent psychiatry and schizophrenia recommended by NICE, NICE guidelines for adult psychosis and schizophrenia, and psychosis And the NICE quality for adults with schizophrenia. It is standard. Family intervention and antipsychotics were offered. Proposals should be made for those more effective combinations. If a child or adolescent is intervened psychologically without antipsychotics, he or she should agree on a one – month deadline to review the treatment plan.

Schizophrenia rarely happens to children, but awareness of childhood schizophrenia is increasing. Furthermore, it may be difficult to diagnose schizophrenia in adolescence. This is because the first signs of the disease may include changes in friends, declining grade, sleeping disorders, and adolescent hypersensitivity. By combining multiple factors, you can predict schizophrenia with up to 80% of young people who are at high risk of developing. These factors include isolation and withdrawal from others, increased abnormal thinking and doubt, and family history of mental illnesses. In young people with this disease, when the symptoms are ambiguous and easy to overlook, the stage of disease is called the prodromal stage.Psychosis In Children Essay

Schools are ideal places to establish child behavior and learn about their mental status. At the same time, they are places where programs are installed to ensure that children and teenagers are in their right state of mind to learn. These settings are responsible for shaping the children and adolescents’ relationships and other interactions, their academic achievements and all these are related to mental health. It is the role of the school counsellors, teachers and parents to work as a team towards the betterment of their children’s lives. High-income countries have expanded school-based mental programs that will increase the awareness of psychological disorders among children and seek to reinstate them to boost academic performance and allow for the best behaviors among children and adolescents. An excellent program is that which integrates neuroscientific information to understand the nervous system of an individual thus comprehend the impact of the mental disorders and what causes them. The paper will begin by discussing how a neuroscientific approach for mental health would look like and thereafter refer to a program on the early onset of children and adolescents and critique since it is not up to date with the neuroscientific information as its foundation.Psychosis In Children Essay

First, it is important to understand what a neuroscientific approach looks like and what neuroscience deals with. Neuroscience is a branch of science that studies about the nervous system and combines other disciplines such as psychology, cytology, physiology and biology to understand the function of the neurons in humans. It also seeks to explain why the behaviors of neurons in the brains affect the behavior of people making them behave the way they do. The past few decades have experienced great advancements in neuroscience where professionals have been able to see an inside of a human brain through neuroimaging (Lambert, 2005). Even though the popularity of these advances have taken the world by storm, it is still sad that not much progress has been yielded in finding solutions for those who are mentally ill. Instead, therapy and counselling sessions are still the most utilized interventions that are used to attend children and adolescents with mental dysfunctions.

The director of the National Institute of Mental Health’s Research Domain Criteria Initiative, Sarah Morris, points out that much has to be done to increase the move towards the use of neuroscience in treating mental disorders especially in children and adolescents found in a school setting. One of the most famous models used to assess mental illnesses is the circuit method which has been in practice since the Freudian days (White, 2016). The circuit approach is neuroscientific because it sees the brain as a network of circuits and observes these circuits to study patients’ symptoms that will provide a basis for starting the treatment process. The model combines the traditional methods for diagnosing mental illness with the behavior and pattern of neurons to understand how a mental illness develops and progresses to the extent of impacting the child’s development (Luke, Miller & McAuliffe, 2019). The circuit approach focuses on the activities of thousands of neurons with each other through electrical signals. This neuroscientific approach goes beyond the usual diagnosis of mental illnesses where a therapist interviews a patient and goes ahead to study the inside of the brain to reveal what exactly root cause of mental disorders.Psychosis In Children Essay

The reason why the circuit approach has been embraced in the field of mental health is its ability to take the scientific path for a more advanced diagnosis to arrive at concrete information about an illness. The goal is to eliminate the stigma faced by people suffering from mental illness as the public often view it as an individual failure and not a biological discourse. The world still have a long way to go and too much to learn before they accept that mental illness is not a weakness but rather its due to malfunctioning of some parts of the brain (Lambert, 2005). The study of the neurons will explain why some people suffer from different mental issues and thus be able to explain the defects that the neurons are causing in the brain making individuals behave in some abnormal ways compared to others (Luke, Miller & McAuliffe, 2019). Currently, the field of psychology fails to look at the brain when attempting to make a diagnosis and this is one mistake that these health practitioners are making. The same way a heart doctor looks at the heart when an individual complains of having pain or problems in the area is the same way that mental health professionals should look at the brain to establish a cause.Psychosis In Children Essay

Leanne Williams is a neuroscientist at Stanford University and after leaving her work as a therapist, she delved into research of the brain. One thing she has realized is that the lives of all individuals will change if personalized neuroscience is applied on each patient (White, 2016). She is saddened that little has been done so far despite the full knowledge that neuroscience would inform the field of mental health and solve the problems that the field is currently grappling with. Williams currently works on a project known as the Research on Anxiety and Depression (RAD) which is funded by the National Institute for Mental Health (NIMH) (White, 2016). Williams is the first person to conduct a study that combines several neurobiological tests like brain scans with the social wellbeing of an individual to make accurate diagnoses and offer the right treatment to the patients with mental illnesses. She has made several trials with the key aim of finding the biological markers that distinguish different mental illnesses and points out the vitality of both neuroscientists and psychologists working together to find the ultimate treatment for these patients.Psychosis In Children Essay

A neuroscientific approach would not take for granted the brain when making diagnosis but this has been happening daily. It is high time the brain was checked and several scans run to identify the behavior of the neurons ad how it is causing defects and this is through examination of the brain circuits. Williams give an example of a neuroscience approach when she did a test on 60 year old woman who had had panic episodes and depressions for the longest period. She was placed in a brain scanner at the university and she agreed to undergo the RAD test because she wanted to see inside her brain and probably understand what has been causing her troubles (White, 2016). A screen was placed in front of her face which has both sad and happy faces and the patient was required to press either of the buttons for happy and terrified faces. The tests were to be carried out during her entire time in the brain scanner and it was expected that each time, brain circuits would be activated. According to Williams, the many tests taken are supposed to exercise the brain.

Since Williams began her RAD project in Stanford, she has been performing tests to many participants with mental issues. These people have seen the need to personally study their brains with the help of a neuroscientist before a psychologist makes a diagnosis. During the tests, the participants are expected to give a swab of saliva (White, 2016). This practice is critical because it helps in genetic tests for investigating the antidepressant effectiveness and the how the brain circuits are affected by the differences in genetics. After the participants have conducted tests in the MRI machines, they later undergo evaluations by the psychologists.Psychosis In Children Essay

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When the tests come out, any abnormalities in the circuits are searched and then a meeting between the neuroscientist, the patients and a therapist is held. Here, possible interventions and treatments are discussed after the therapist defines the problems of the patients and are made to understand the functioning of their brains. Interventions such as psychotherapies, drugs or counselling are then offered depending on the extremity of the case. Follow up exercises are important for the participants to monitor progress and whether the treatments offered have positive impacts (White, 2016).Psychosis In Children Essay

The information from the scans and the therapist’s diagnoses have been found to have more detailed information compared to when the therapist alone conducts the diagnosis. The research director at the Gronowski Center, Nancy Haugh, has reported improved treatment on the patients when the behavior of the neurons is studied (White, 2016). Haugh takes part in the RAD study and helps understand what is going on in the brains of their patients. Sometimes, before the brain scans are conducted, the patients are taken to the therapists first and after that, tests are conducted. Often, the results attained confirm the results that the psychologist had already conducted but in other cases, the results are different prompting other modes of treatment.Psychosis In Children Essay

In the world today, over 500 million people suffer from mental disorders and more than half of these numbers are children and adolescents. School settings and learning institutions have become the hub of these mental illnesses as children and adolescents are exposed to extreme environments. The presence of school counsellors alone has not solved the issue making the mental disorders and the aggressive behaviors associated with them rampant. This causes low academic achievements in schools hence reduced productivity among the students. The existing models in schools where school counsellors are used only treat 30% of the problem and the 70% is left untreated leading to progression of the mental sicknesses (Lambert, 2005). During this time, the brain continues deteriorating explaining the extreme cases of mental issues among children.Psychosis In Children Essay

Every patient ought to be treated differently because there is no definite treatment for the mental problems. Trial and error is what most doctors and therapists do in trying to find the right intervention for their patients and the individuals struggle with the adverse side effects of the new drugs they are given every time they visit the hospitals. According to the assistant professor of psychiatry and behavioral sciences at Stanford Medicine, Amit Etkin, new and advanced drugs will solve mental issues but the current problem is the absence of these medicines. This has made Etkin to go the neuroscientific way to seek further improvements in mental health (White, 2016). Etkin admits that neuroscience practices such as brain stimulation have resulted in positive results hence a platform for providing the treatment for cognitive disorders. Deep brain stimulation trigger the circuits that assists the neuroscientist understand the activities and the defects in the brain.Psychosis In Children Essay

An active part in research as at now is brain stimuluses and activities like transcranial magnetic stimulations are the common ones, Etkin reports. He has confirmed that indeed, these are advances in the mental health field and if brain scans are used in children and adolescents, mental health professionals will be able to detect cognitive defects. As such children will immediately be placed in treatment before the inception of signs and symptoms (White, 2016). He says that the brain scans should be likened to cancer screenings or other tests done when checking for chronic diseases. If people could wait until they start experiencing the symptoms of cancer, then they would have waited for far too long and there are slim chances of coming out if. The same case should apply for mental illness such that early detection leads to prompt treatment.

Apart from the RAD, there is another trial, iSPOT-D, that is currently being conducted at the University of Texas Southwestern Medical Center which attempts to find biological markers. These markers are important in establishing the reaction between depression and anxiety disorders with treatment. Recently, a biomarker was identified by Helen Mayberg, a psychiatrist professor at the Emory University. The identification made headlines in the social media because this is one rare occurrence. This marker dictates the kind of treatment that best suits the depressed patient because not all need medication while others respond well to therapies. Having researched and found these possible outcomes, Mayberg is more than willing to delve more into neuroscience to solve mental issues. The world would be a better place if everyone thought of the brain when the issue of mental issues comes up instead of seeing it as the fault of the patient. Williams noticed that if the brain scans show low activity in the amygdala, then the best medication would be Zoloft and Prozac instead of Cymbalta and Effexor. The amygdala in the brain is responsible for emotions. In other words the right treatment for this condition is the Selective Serotonin reuptake inhibitor (SSRIs) and not the Serotonin–norepinephrine reuptake inhibitor (SNRIs).Psychosis In Children Essay

The RAD study is the excellent approach where physicians will treat a depressed patient by running neurobiological tests to get more insight on what is going on so that appropriate treatment is provided. It is important to note that even though there are patients suffering from anxiety, depression and schizophrenia, every person will elicit distinct symptoms. Therefore, the causes of these disorders are distinct and should not be offered the same treatment but sadly, this has been taking place. Williams points out that the significance of the study is to classify the diagnoses into categories centered on the dysfunctions of the brain circuits. Just as there are trials and errors in the traditional methods of diagnoses, clinical trials should also be done to prove the effectiveness of neuroscience to treat mental illness and eventually shift from therapy to research.Psychosis In Children Essay

The circuits from people with depression and anxiety are taken and then compared with circuits taken from healthy people. The comparison is important to look out for nonconformities between the two circuits which will in return provide a platform for making appropriate diagnoses. Neuroscientists like Williams assert that they are not only employing science to treat mental issues but are also trying to link it with the social life of the patients. They achieve this by researching the quality of life that the patients are living as well as their experiences in the work environment. The other thing they want to identify are the different ways used by these people to cope with emotions because all these reflect on how their brains functions and respond to the society in different ways.

Williams says that offering personalized psychiatry is critical in providing the right treatment for the patients. She adds that during her entire time as a neuroscientist, she has been able to create healthy relationships with clinicians who are constantly in contact with children and adolescents suffering from mental illnesses. Williams posit that the creation of these relationships has created a pool of ideas where the practitioners can meet and generate the right treatments for patients because of the efficient communication developed. She gives an example of how one worker who works in the engineering department experience difficulties concentrating at work if he does not have a nap. When Williams mapped the circuits in the brains of the engineer, she realized that when at rest he would have negative modes and this is attributed to the engineer’s ‘default mode’ circuit being on overdrive. As such he found himself depressed and could not pay attention when working.Psychosis In Children Essay

Williams confirms that providing personalized treatment on every child and adolescent with neurological disorders might be difficult as at now but it is high time it was tried. She believes that the move towards a neuroscientific approach will solve the difficulties that arise with mental problems. The early onset of mental disorders in children and adolescents will come to an end if the neurological tests are done on young children. Suitable measures such as the use of antidepressant drugs or therapies will be employed before these children become adults. There are several neuroscientific tests that have been done and they are safe to be conducted in school settings.

The above discussion has provided a clear picture of what a neuroscientific-informed approach would look like. The many examples provided by different neuroscientists shows how much they are enthusiastic about applying neuroscience to solve complex mental issues. Young children and adolescents ought to be the main targets for neuroscientific approaches because they constitute a larger percentage of people suffering from mental illnesses. Psychologists, therapists, parents and doctors should ask themselves why the mental conditions keep coming back. This is because the appropriate treatment which in this case is neuroscience has not been fully embraced.Psychosis In Children Essay

There are many school-based mental programs that have been put in place to help children and adolescents with early onset of mental disorders, early instances of aggressiveness and other neurological disorders in a school setting. The following discussion will be a critique of such a program because it is does not utilize neuroscientific information as its underpinning. The program in picture is the PAX Good Behavior Program which is one of the most utilized school-based prevention programs for children with mental illness.

The main goal of PAX GBG is to improve student attainment by ensuring that children are in their best mental state. The model is mostly used in middle childhood because it is believed that this is the age when children go to school and interact with other new children. Also, this is the right time for schools to begin addressing the importance of mental state to children. There is need for the implementation of tools that will ensure early intervention and to look out for any early signs and symptoms of mental illness and provide the necessary attention. The exact programs that schools should look for and employ are those that accommodate a full classroom and in addition, offer variety of mental health facilities that have impact on an individual child and that which can positively impact their development. However, more attention should be on those children with the risk of developing mental issues when they are still young.Psychosis In Children Essay

The PAX GBG is a game played mostly by children in elementary schools to advocate and promote good behavior while decreases the unwanted ones. PAX has been used in several schools in the United States because it has been found to have positive results for instance; institutions which apply this program have noted that there is 45-90% decrease in bad behaviors and a 12% decrease in the urgency of special attention to children (Embry, 2002). Also, the percentage of children required to transfer has reduced to 30% which is a sign that children are at their best behaviors and are in the right mental state that boost academic attainment hence proper transition between classes (Embry, 2002).

The first limitation, however, is the fact that PAX GBG does not apply any science for early intervention of child mental issues. As earlier on discussed, a neuroscientific approach is that which involves brain scanning to check the behavior of circuits in individual people and thereafter present the results to a therapist who will then offer a prescription. Even though the PAX GBG model is used in elementary to curb disruptive behaviors in later life, it does don’t give an extensive explanation of how mental illness will be handled in this period (Embry, 2002). Since children and adolescents are the main targets, the PAX GBG would begin with examining the brains of children before enrolling them to school. Keeping these records will make teachers and school counsellors to understand their students and look out for any symptoms of mental illness.Psychosis In Children Essay

PAX GBG has a long-term impact on the mental health on children especially those characterized by extreme aggression and anxiety disorders. The reason for this is that when these children play the PAX GBG when in their first grade, they adopt the best behaviors and learn to relate well with others. Therefore, as they advance in age, there is no need for them to be taken to special institutions since of the reduced levels of aggression, thus can relate well with others. Consequently, they are 20% less likely to develop mental disorders in their adulthood (Embry, 2002). One good thing with the program is that it leads to the total reductions of suicide attempts and thoughts.

The PAX GBG is an instance where children learn to work together in groups and assist one another when there are difficulties. Rewards are offered for good behaviors and punishment is presented when unwanted behaviors are realized. The reason why there are little or no cases of suicides and other personality disorders later in life in adolescents is attributed to this program. Children in this program are taught the significance of creating a positive future together and develop skills that are useful when they are adults (Embry, 2002). These skills are mostly behavioral, cognitive and emotional that will tune the child in the right path of happier and healthier lives.Psychosis In Children Essay

Again, this program shows promising results in the lives of children as it seeks to prevent early onset on mental illnesses and other neurological disorders. However, it fails to provide a clear path for long-term results that will ensure that the child does not relapse or the mental illness will not occur. Unlike the neuroscientific approach where the cause of the problem is established from the brain scans and the neurological tests such as deep brain imaging, the PAX GBG only deals with the outside of the patient which neuroscience wants to eliminate. A neuroscientific approach does not simply make assumptions on the kind of treatment that is best for children. It is different from the PAX GBG approach because neuroscience attends to every patient individually through brain examination (Embry, 2002). Unlike PAX GBG where children and adolescents are placed in clusters and their behaviors monitored based on these groups, neuroscience conducts test in the brains of these patients and come up with the ultimate problem. PAX GBG places children in groups and provide communal treatment without acknowledging that children are different and what is best for one person may not work for the other individual.Psychosis In Children Essay

The whole of Canada and the United States have stated that PAX GBG is one of the most operative schemes that teachers can utilize to boost long-term academic success on children. Apart from this, children are also safeguarded from the early onset of mental and neurological disorders as well as behavioral problems that will impact their later life. This is one milestone that the PAX GBG approach has succeeded to attain and it goes in line with the goal of the neuroscientific approach of preventing the onset of personality and neurological disorders (Embry, 2002).

The discussion has critiqued the PAX GBG program because there is no instance that it recognizes the use of neuroscience to tackle mental issues in children and adolescents. The approach only deals with children playing games with the aim of encouraging the best behaviors. Teachers should work in collaboration with the doctors who will in turn partner with neuroscientists to ensure that students receive the best care. However, before this is done, creation of awareness and sensitization is critical for all the parties involved so that they are aware of what exactly is taking place. As Williams admits, neuroscience will take mental health to the next step and within no time, reduction in early onset of mental disorders will be realized.Psychosis In Children Essay

The reason why schools are the ideal places for creating sensitization is because of the different kinds of behaviors that are present in this environment. Therefore, it will be easy to treat each student singly other than viewing them as a whole. The importance of neuroscience is that the first step it makes before diagnosis is to monitor the nervous system and check for any defect. It is from the results attained that therapists can use them as foundation to treat the diseases before they advance. Provision of both the SSRIs and the SNRIs depends on what the neuroscientists find in the brain. Schools that are currently using PAX GBG should first conduct the tests on children still in elementary so that the game comes later after the problem in the brain has been established (Embry, 2002).Psychosis In Children Essay

In conclusion, the paper has broadly discussed how a neuroscientific approach would look like and the need for the existing programs to adopt neuroscience in their approach. The PAX GBG is the program that is currently being recognized in several countries such as the United States, Canada and the whole of Europe. It has succeeded in instilling good behaviors and reducing unwanted ones because it is used during children’s early ages. However, its failure to utilize neuroscience as its platform is the reason why there are many cases of relapse in these children. The example of Williams has been used in this case to broaden the understanding of how a neuroscientific approach would help children with early onset in schools. Therefore, hospital practitioners ought to indulge in more research concerning the importance of neuroscience to treat children and adolescents. This should be done especially in public school settings where interactions are more and they are likely to get exposed to extreme conditions which will impact negatively on their mental health. Psychosis In Children Essay

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