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Diagnostic Challenges in Children and Adolescents With Psychotic Disorders

J. Philip Reimherr, MD, FAACAP; and Jon M. McClellan, MD

Published: April 1, 2004

Article Abstract

The diagnosis of psychotic disorders in children and adolescents is often complex and challenging.The symptomatic overlap between different psychotic conditions and other emotional, behavioral,and developmental disorders has led to high rates of misdiagnosis, especially at time of onset. Theclinical expression and progression of diagnosable disorders are affected by maturational processes.Thus, psychotic illnesses in pediatric patients may vary from adult presentations because of developmentalfactors. Establishing a specific diagnosis is difficult when the differential diagnosis comprisesdisorders that share common symptoms and are frequently comorbid. The clinical assessment dependsas much on input from parents and teachers as from the patients themselves, and there may be conflictbetween these different perceptions. This article reviews recent research and current concepts relatingto diagnostic challenges in pediatric psychiatry.

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