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James B. McCarthy

Pace University, USA

Title: Pediatric Psychotic Disorders and the Role of Psychotherapy


Biography: James B. McCarthy


Psychotic symptoms are moderately widespread in child and adolescent psychiatric disorders and are somewhat frequent in children who have been the victims of maltreatment by adults. The incidence of discreet psychotic symptoms among children and adolescents in the United States is between 8% and 9% of the general population.  Aside from psychotic symptoms associated with medical conditions, psychotic manifestations of severe mood disorders, such as Major Depressive Disorder or Bipolar Disorder have the greatest frequency in addition to the intermittent psychotic features associated with Posttraumatic Stress Disorder (PTSD) in highly traumatized children and youth. There have been groundbreaking advances in understanding the genetics, neurobiology, etiology and developmental course of psychotic disorders in children and adolescents as well as the appropriate utilization of antipsychotic medications. However, psychotic disorders often interrupt cognitive, social and emotional development in children and adolescents leading to noticeably compromised functioning. Several studies colleagues and I and other investigators have conducted suggest that children and adolescents with psychotic features associated with mood disorders have greater cognitive deficits than those who have mood disorders without psychotic features; in addition, cognitive and social declines in children and adolescents with schizophrenia have been well documented. Although there are developmental differences in the symptoms of psychotic disorders and there is considerable variability in the outcome of patients with pediatric psychotic disorders, there is a continuity of psychotic disorders from childhood to adolescence to adulthood. There is thus a critical need for research on the role of psychotherapy, supportive services and cognitive interventions that may help to improve the functioning of very high risk children and those with psychotic disorders. Individual psychotherapy approaches with psychotic children aim to improve reality testing, coping skills and anxiety tolerance while examining the stimuli for the exacerbations of their experience of stress and anxiety.  Studies on family-based psychotherapeutic interventions consistently point to the need for supporting family members and their efforts to try to restore the psychotic child’s age-appropriate functioning.