Hallucinatory Phenomena in Childhood: A Critique of the Literature

Phenomenology of Childhood Psychosis

“…It has been estimated that psychosis afflicts approximately 1% of youth in community samples (Lohr and Birmaher, 1995) and 4% to 8% of referred samples (Caplan and Tanguay, 1996;Volkmar, 1996). Despite its apparently high prevalence, child and adolescent psychosis has continued to receive limited scientific attention outside the context of a narrowly defined childhood-onset schizophrenia (Del Beccaro et al, 1988;Fard et al, 1978;Garralda, 1984Garralda, , 1985Lukianowicz, 1969;Rothstein, 1981;Schreier, 1999), despite the fact that recent studies of clinical (Ulloa et al, 2000) and community (McGee et al, 2000;Schreier, 1999) populations have noted hallucinations and delusions in a wide spectrum of pediatric patients.…”

“…The few studies that examined childhood-onset psychosis documented that the most common diagnoses in youth who experience hallucinations and/or delusions are mood, schizoaffective, and schizophrenic disorders (Chambers et al, 1982;Lohr and Birmaher, 1995;McKenna et al, 1994;Russell et al, 1989;Volkmar, 1996), although psychotic-like phenomena have been reported in anxiety, disruptive behavior, substance use disorders, and PTSD as well (Altman et al, 1997;Aug and Ables, 1971;Del Beccaro et al, 1988;Garralda, 1984aGarralda, , 1984bKaufman et al, 1997;Kotsopoulos et al, 1987;Lohr and Birmaher, 1995;McKenna et al, 1994;Rothstein, 1981;Schreier, 1998;Volkmar, 1996). One follow-up study of childhood psychotic patients found that half progressed to chronic psychosis in adulthood (Dahl, 1976).…”

Stimulant Medication and Psychotic Symptoms in Offspring of Parents With Mental Illness

“…[37][38][39] It should be noted that most stimulantassociated psychotic symptoms were hallucinations and there is lack of consensus about the predictive value of hallucinations in children. Some authors suggest that hallucinations in children have a relatively good prognosis [37][38][39][40] unless they are accompanied by delusions. 41,42 On the other hand, PLEs that were overwhelmingly hallucinations predicted psychotic symptoms and disorders in adulthood in several large cohorts.…”

Childhood and Adolescent Schizophrenia and Other Early-Onset Psychoses

“…Beliefs in fantasy figures, imaginary friends are common in preschool children. Transient psychoticlike symptoms, such as hallucinations, can be thus observed in preschool children in relation to stress and anxiety (Rothstein, 1981). Children under 4 years cannot develop typical psychotic symptoms (delusions of persecution or influence) because they lack a fully formed perception of social relations (Remschmidt, 2004).…”