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Assessing and managing hallucinations in children and adolescents

  • Maria-De-Gracia Dominguez and M. Elena Garralda
Summary

Hallucinations (erroneous percepts in the absence of identifiable stimuli) are a key feature of psychotic states, but they have long been known to present in children with non-psychotic psychiatric disorders. Recent epidemiological studies of child populations found surprisingly high rates (about 10%) of hallucinatory experiences. These hallucinatory phenomena are most likely to occur in the absence of psychiatric disorder and are usually simpler, less elaborate and less distressing than those observed in children with psychiatric disorders. This article details the clinical assessment of hallucinations in children and adolescents, taking into account developmental considerations and paediatric organic associations. It describes hallucinations in young people with psychoses (schizophrenia spectrum and mood disorders) and non-psychotic psychiatric disorders (emotional and behavioural disorders), and it addresses therapeutic aspects.

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Copyright
Corresponding author
Dr Maria-de-Gracia Dominguez, Centre for Mental Health, Imperial College London, Hammersmith Hospital Campus, 7th Floor Commonwealth Building, Du Cane Road, London W12 0NN, UK. Email: m.dominquez-barrera@imperial.ac.uk
Footnotes
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LEARNING OBJECTIVES

• Be aware of the frequency, associations and clinical significance of hallucinatory experiences in general populations of children and young people

• Know how to conduct clinical assessments of children and young people presenting with hallucinatory experiences, taking into account developmental considerations

• Be able to recognise the characteristics and clinical associations of hallucinations in children with psychotic and/or non-psychotic disorders and understand the therapeutic implications

DECLARATION OF INTEREST

None

Footnotes
References
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Algon, S, Yi, J, Calkins, ME, Kohler, C et al (2012) Evaluation and treatment of children and adolescents with psychotic symptoms. Current Psychiatry Reports, 14: 101–10.
Askenazy, FL, Lestideau, K, Meynadier, A et al (2007) Auditory hallucinations in pre-pubertal children: a one-year follow-up, preliminary findings. European Child & Adolescent Psychiatry, 16: 411–5.
Barneveld, PS, Pieterse, J, de Sonneville, L et al (2011) Overlap of autistic and schizotypal traits in adolescents with autism spectrum disorders. Schizophrenia Research, 126: 231–6.
Braakman, MH, Kortmann, FA, Van den Brink, W (2009) Validity of ‘post-traumatic stress disorder with secondary psychotic features’: a review of the evidence. Acta Psychiatrica Scandinavica, 119: 15-24.
Casey, P, Brendan, K (2007) Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry (3rd edn). Gaskell.
Chang, K (2009) Challenges in the diagnosis and treatment of pediatric bipolar depression. Dialogues in Clinical Neuroscience, 11: 73-80.
David, CN, Greenstein, D, Clasen, L et al (2011) Childhood onset schizophrenia: high rate of visual hallucinations. Journal of the American Academy of Child and Adolescent Psychiatry, 50: 681–6.
de Leede-Smith, S, Barkus, E (2013) A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals. Frontiers in Human Neuroscience, 7: 367.
Despert, JL (1948) Delusional and hallucinatory experiences in children. American Journal of Psychiatry, 104: 528–37.
Dikeos, DG, Wickham, H, McDonald, C et al (2006) Distribution of symptom dimensions across Kraepelinian divisions. British Journal of Psychiatry, 189: 346–53.
Dominguez, MDG, Saka, MC, Lieb, R et al (2010) Early expression of negative/disorganized symptoms predicting psychotic experiences and subsequent clinical psychosis: a 10-year study. American Journal of Psychiatry, 167: 1075–82.
Dominguez, MDG, Wichers, M, Lieb, R et al (2011) Evidence that the onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study. Schizophrenia Bulletin, 37: 84-93.
Edelsohn, GA (2006) Hallucinations in children and adolescents: considerations in the emergency setting. American Journal of Psychiatry, 163: 781–5.
Freudenreich, O, Schulz, SC, Goff, DC (2009) Initial medical work-up of first-episode psychosis: a conceptual review. Early Intervention in Psychiatry, 3: 10-18.
Fusar-Poli, P, Bechdolf, A, Taylor, MJ et al (2013) At risk for schizophrenic or affective psychoses? A meta-analysis of DSM/ICD diagnostic outcomes in individuals at high clinical risk. Schizophrenia Bulletin, 39: 923–32.
Garralda, ME (1984a) Hallucinations in children with conduct and emotional disorders: I. The clinical phenomena. Psychological Medicine, 14: 589–96.
Garralda, ME (1984b) Psychotic children with hallucinations. British Journal of Psychiatry, 145: 74–7.
Garralda, ME (1984c) Hallucinations in children with conduct and emotional disorders: II. The follow-up study. Psychological Medicine, 14: 597-604.
Garralda, ME (1985) Characteristics of the psychoses of late onset in children and adolescents: a comparative study of hallucinating children. Journal of Adolescence, 8: 195-207.
Haddock, G, McCarron, J, Tarrier, N et al (1999) Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine, 29: 879–89.
Jardri, R, Bartels-Velthuis, AA, Debbane, M et al (2014) From phenomenology to neurophysiological understanding of hallucinations in children and adolescents. Schizophrenia Bulletin, 40 (suppl 4): S221-32.
Kay, SR, Fiszbein, A, Opler, LA (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13: 261–76.
Kelleher, I, Connor, D, Clarke, MC et al (2012a) Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychological Medicine, 42: 1857–63.
Kelleher, I, Keeley, H, Corcoran, P et al (2012b) Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies. British Journal of Psychiatry, 201: 26-32.
Kowatch, RA, Youngstrom, EA, Danielyan, A et al (2005) Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents. Bipolar Disorders, 7: 483–96.
Linscott, RJ, van Os, J (2013) An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine, 43: 1133–49.
National Institute for Health and Care Excellence (2013) Psychosis and Schizophrenia in Children and Young People: Recognition and Management (Clinical Guideline CG155). NICE.
Nijboer, M (2015) Validating the Questionnaire for Psychotic Experiences (Masters Thesis). Faculty of Social and Behavioural Sciences, University of Utrecht.
Pearson, D, Rouse, H, Doswell, S et al (2001) Prevalence of imaginary companions in a normal child population. Child: Care, Health and Development, 27: 13-22.
Piaget, J (1932) Le jugement moral chez l'enfant . Reprinted (1997) as The Moral Judgment of the Child (trans M. Gabian). Free Press Paperbacks.
Scott, J, Martin, G, Bor, W et al (2009) The prevalence and correlates of hallucinations in Australian adolescents: results from a national survey. Schizophrenia Research, 107: 179–85.
Shears, D, Elison, S, Garralda, ME et al (2005) Near-death experiences with meningococcal disease. Journal of the American Academy of Child and Adolescent Psychiatry, 44: 630–1.
Smeets, F, Lataster, T, Dominguez, MDG et al (2012) Evidence that onset of psychosis in the population reflects early hallucinatory experiences that through environmental risks and affective dysregulation become complicated by delusions. Schizophrenia Bulletin, 38: 531–42.
Smith, RA, Wright, B, Bennett, S (2015) Hallucinations and illusions in migraine in children and the Alice in Wonderland Syndrome. Archives of Disease in Childhood, 100: 296–28.
Thapar, A, Heron, J, Jones, RB et al (2012) Trajectories of change in self-reported psychotic-like experiences in childhood and adolescence. Schizophrenia Research, 140: 104–9.
Thomas, N, Hayward, M, Peters, E et al (2014) Psychological therapies for auditory hallucinations (voices): current status and key directions for future research. Schizophrenia Bulletin, 40 (suppl 4): S202-12.
Tillman, R, Geller, B, Klages, T et al (2008) Psychotic phenomena in 257 young children and adolescents with bipolar I disorder: delusions and hallucinations (benign and pathological). Bipolar Disorders, 10: 45-55.
Ulloa, RE, Birmaher, B, Axelson, D et al (2000) Psychosis in a pediatric mood and anxiety disorders clinic: phenomenology and correlates. Journal of the American Academy of Child and Adolescent Psychiatry, 39: 337–45.
van Rossum, I, Dominguez, MDG, Lieb, R et al (2011) Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. Schizophrenia Bulletin, 37: 561–71.
Varese, F, Barkus, E, Bentall, RP (2012) Dissociation mediates the relationship between childhood trauma and hallucination-proneness. Psychological Medicine, 42: 1025–36.
Vickers, B (2002) Case study: the treatment of auditory hallucinations in children with emotional disorders. Child and Adolescent Mental Health, 7: 25-30.
Waters, F, Collerton, D, Ffytche, DH et al (2014) Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophrenia Bulletin, 40 (suppl 4): S233-45.
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO.
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BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
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Assessing and managing hallucinations in children and adolescents

  • Maria-De-Gracia Dominguez and M. Elena Garralda
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