Psychosis is not common, and the way it affects young people is different for everyone. Often young people find that their mood, thoughts, experience of the world and behaviour are all affected. It is important to remember that everyone is unique and their experience of psychosis will reflect their developmental level and their circumstances.
Generally the presentation of psychosis is divided into ‘positive symptoms’ such as delusions (beliefs which are fixed and false), hallucinations (perceptions which not caused by stimulus) and ‘negative symptoms’ such as reduced motivation and speech, blunting of emotions, reduced self care and social withdrawal. Sometimes young people have very brief episodes of psychosis which do not occur more than once. Sometimes psychosis is part of mental health conditions including schizophrenia and severe mood disorders.
What causes it?
We are still learning about psychosis and what causes it. There does seem to be evidence that it is connected to problems with the functioning of dopamine pathways of the frontal and temporal lobes of the brain. Having family members with psychosis does seem to make it more likely that other members of the family will experience psychosis. Physical health problems can lead to symptoms of psychosis such as problems with thyroid function and anaemia. Sometimes if young people use street drugs they can have symptoms of psychosis.
Psychosis is very rare in children and young people. Generally only about 0.4% of people between 5 – 18 years experience psychosis. Psychosis is more common in people over the age of 15.
Young people are often treated in Early intervention services (EIS) these services were introduced in 2000. Typically they work with people between 14 – 35 years. EIS will work with CYP with at risk mental states or psychosis for an average of 3 years. An early intervention service has a number of key functions i) reduce stigma ii) reduce the length of time young people remain undiagnosed and untreated iii) develop meaningful engagement, provide evidence-based interventions and promote recovery during the early phase of illness iv) increase stability in the lives of service users, facilitate development and provide opportunities for personal fulfilment v) provide a user-centred service ie. a seamless service available for those from age 14 to 35 that effectively integrates child, adolescent and adult mental health services and works in partnership with primary care, education, social services, youth and other services vi) ensure that the care is transferred thoughtfully and effectively at the end of the treatment period.
What CAMHS can do to help
Psychosis can be really frightening. If families, CAMHS or other professionals think that a young person has psychosis then it is important to meet with the child or young person and try to learn what is happening. Often we will be able to explain that we do not think this is psychosis, sometimes we will need to refer people to the early intervention service.