Psychosis and schizophrenia in children and young people: recognition and management

National Institute for Health and Care Excellence


Key priorities for implementation

  • The following recommendations have been identified as priorities for implementation

Referral from primary care for possible psychosis

  • When a child or young person experiences transient or attenuated psychotic symptoms or other experiences suggestive of possible psychosis, refer for assessment without delay to a specialist mental health service such as CAMHS or an early intervention in psychosis service (14 years or over)
  • Treatment options for symptoms not sufficient for a diagnosis of psychosis or schizophrenia
  • When transient or attenuated psychotic symptoms or other mental state changes associated with distress, impairment or help-seeking behaviour are not sufficient for a diagnosis of psychosis or schizophrenia:
    • consider individual cognitive behavioural therapy (CBT) with or without family intervention, and
    • offer treatments recommended in NICE guidance for children and young people with any of the anxiety disorders, depression, emerging personality disorder or substance misuse
  • Do not offer antipsychotic medication:
    • for psychotic symptoms or mental state changes that are not sufficient for a diagnosis of psychosis or schizophrenia, or
    • with the aim of decreasing the risk of psychosis

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