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New NICE guidelines on schizophrenia and psychosis in children

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New clinical guidelines for recognising and managing schizophrenia and psychosis in children and young people have been published by NICE.

Draft recommendations for healthcare professionals were posted on the NICE website on August 9, as part of the board’s current review of the issue.

The recommendations publicly detail issues regarding the diagnosis and management of psychosis, the most common form of which is schizophrenia. About 1% of people will develop the condition over their lifetime, but it is most common between the ages of 15-35.

The new guidelines state:

  • If a child or young person experiences transient psychotic symptoms or other experiences suggestive of possible psychosis, they should be referred to a specialist mental health service for assessment without delay.
  • Antipsychotic medication should not be offered where psychotic symptoms or mental state changes are insufficient for a psychosis or schizophrenia diagnosis. It should also not be offered with the aim of decreasing the risk of psychosis.
  • A time limit of one month or less should be agreed for reviewing treatment options, including introducing antipsychotic medication.
  • Careful thought should be given to the possible impact on the child or young person and their parents, carers and family members before any referral for hospital care is made. This is particularly important if it means the patient will be a long way from home.
  • Where applicable, efforts should be made to liaise with the child or young person’s school and educational authority to ensure that ongoing education is provided.

Director of the centre for clinical practice at NICE, Professor Mark Barker, said: “This draft guidance issued for public consultation includes a number of recommendations to support healthcare professionals to accurately diagnose psychosis and schizophrenia in children and young people and offer them treatment options that are best suited to them.

“The guidance also makes clear recommendations on ensuring children and their families or carers have all the information and support they need, encouraging doctors to consider the impact of the diagnosis and treatment.”

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