The treatment of psychotic disorders in adolescents
Treatment for psychotic disorders involves a multi-intervention approach, encompassing various branches of mental health. The treatment of choice is psychiatric and pharmacological, combined with psychological therapy.
Psychiatric treatment: first line of intervention
Psychiatric or pharmacological treatment is the first line of intervention for psychotic disorders and may be necessary in most cases. The psychiatrist will assess the need for appropriate pharmacological intervention. The medications usually used are called antipsychotics and focus on improving positive psychotic symptoms, primarily. However, it is difficult to know how each medication will act on an individual, so sometimes other medications are required, such as mood stabilizers, antidepressants, anxiolytics, or other drugs. The psychiatrist will determine the best treatment in each individual case, and it is very important to follow the psychiatrist's instructions and not to be concerned about whether the medication is the same or different from what someone else is taking.
The importance of early intervention in psychosis
Antipsychotic drugs, like all psychotropic medications, are drugs that act on the nervous system and help to compensate for the imbalances that cause symptoms. There are several categories; among the most representative are first-generation (or typical) antipsychotics and second-generation (or atypical) antipsychotics. First-generation antipsychotics appeared first, and although they are less commonly used today, the psychiatrist will assess the best treatment in each case. Some examples of this category are haloperidol and chlorpromazine. Second-generation antipsychotics are the ones administered in most cases today. They generally produce fewer adverse effects, although it's important to note that each person is different. Some of these drugs include aripiprazole, quetiapine, and risperidone, among others.
One of the most common concerns during consultations is the question of how long the treatment should last or whether it will negatively affect our son or daughter . As explained, each person requires a different intervention, and it is very important to consult with a healthcare professional about any doubts we may have regarding medication. However, one of the factors most strongly associated with the recovery and improvement of those affected is proper follow-up and adherence to the treatment plan.
It is important to understand that evidence has shown that the time that passes without treatment for a person who develops a first psychotic episode is a poor prognostic factor for the disease, so it is necessary to follow the instructions of the referring psychiatrist.
Psychological treatment: treatment of choice cognitive-behavioral therapy
Psychological treatment is also a treatment of choice for psychotic disorders. In this regard, cognitive-behavioral therapy (CBT) has shown the highest level of effectiveness. Within the intervention provided by a psychology professional, the objectives focus on psychoeducation, stress management, and social skills training as the most relevant areas of intervention.
Other relevant treatments
Although the treatments of choice and those with the strongest scientific evidence are those already mentioned, there are other interventions that also have a favorable level of evidence.
Cognitive rehabilitation
Several psychotic disorders are associated with cognitive deficits that primarily affect memory, executive functioning, attention, and social cognition, among other abilities. This impairment is directly linked to the functional capacity of individuals with psychotic disorders, impacting academic performance in adolescents and becoming a source of associated stress for those affected.
Therefore, one of the first-line treatments recommended by clinical guidelines is cognitive rehabilitation. This treatment is carried out by neuropsychologists and involves training in the aforementioned cognitive functions through various cognitive stimulation exercises. Currently, interventions are conducted both on paper and using computerized methods, with both showing favorable levels of evidence.
Family therapy
Given that family climate and expressed emotions have been identified as risk factors for relapse, family therapy aims to identify and modify communication styles that cause distress both within the family and for the affected individual. Furthermore, family psychoeducation has also proven relevant for both treatment adherence and the overall management of the situation by the family.
Academic support and social assistance
The academic and social impact, as well as the stigmatization and discomfort that psychotic disorders entail, makes the help received in these two areas very beneficial.
This is an original article from the 12th FAROS Report "A look at the mental health of adolescents - Keys to understanding and supporting them".
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