peds schiz

Question 1

Early onset?
Childhood onset?
peak age of schiz?

Answer 1

less than 18
less than 13
15-30

Question 2

in youth schiz:
more consistently found sx (3)
less(2)

Answer 2

More: hallucinations, thought DP, flat affect
Less: cataonia, systematic delusions

Question 3

high risk factors of schiz

Answer 3

family history and decreased function
unusual thought content
increasing social impairment
hx of substance abuse

Question 4

environmental RF?

Answer 4

paternal age
THC
immigration
maternal famine and infection
perinatal complication

Question 5

neuro findings in youth schiz?

Answer 5

increased ventricles

decreased frontal lobe, thalamus and hippocampus

Question 6

death rate in youth with schiz?

Answer 6

5%

suicide and accidental death due to psychotic thinking

Question 7

what medication to start in youth schiz?

Answer 7

typically, an AA
although EUFEST, TEOSS, CATIE and CUTLASS show that 1st and 2nd equivalent
FDA approved >13: Haldol, Risperdal, Quetiapine, Olanzapine, Aripiprazole, paliperidone
Zipraz had -ve studies so not recomended
Depot and ECT for adolescents only if really justified
Clozapine , get 2nd opinion if < 12

Question 8

evidence for omega 3 FA in high risk youth

Answer 8

1 RCT: may delay 1st episode