Article by Gabrielle Carlson Reviews Psychosis in Mood Disorders in Youth

Gabrielle Carlson, MD

October 28, 2013 – In a review article published in the current edition of Child and Adolescent Psychiatric Clinics of North America Gabrielle Carlson, MD presented an overview of psychosis in mood disorders in children and adolescents. The article was part of a series of 18 articles devoted to the topic of identifying and treating psychosis in children and adolescents.

In her review, Dr. Carlson pointed out that the role of psychosis in mood disorders in adolescents assumed clinical significance in the 1980’s after lithium carbonate was approved for the treatment of mania, prompting psychiatrists to more carefully distinguish mania with psychosis from schizophrenia, especially in young people where schizophrenia had always been the default diagnosis in psychosis.

Despite the importance of psychosis in mood disorders, several issues complicate its study — including a common failure to recognize that psychosis is a state rather than a trait, that is, in recurrent mood disorders, not every episode is psychotic. Estimates of rates of psychosis in youth with mood disorders vary with the type of sample (community versus clinic sample), age, and the type of interview used to identity psychosis. Distinctions must also be made between mania and non-bipolar depression, current symptoms versus lifetime symptoms, and mood-congruent versus non-congruent symptoms.   Most importantly, in children and even adolescents, hallucinations can occur in up to 17% of children in community samples!

After reviewing the definitions and types of positive psychotic symptoms (hallucinations and delusions) in mania and depression, Dr. Carlson pointed out the importance of properly assessing psychosis in mood disorders. She provided tips for taking a proper history of symptoms and for using standardized rating scales.

The article, titled Affective Disorders and Psychosis in Youth, was published in the October 2013 edition of Child and Adolescent Psychiatric Clinics of North America.