Early Onset of Schizophrenia Spectrum Disorder

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Early Onset of Schizophrenia Spectrum Disorder

• Premorbid history

• Language abnormalities

• Social impairment

• Attention problems

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Schizophrenia Biologic Etiology

• Neuropathology in structure, function, and
  neurotransmitters, especially in temporal and
  frontal regions

• Genetic diathesis

• Intra uterine stress

• Neurocognitive impairment

• Language impairment

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Schizophrenia Psychosocial Etiology

• Communication deviance
• Life events and stress

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Schizophrenia Differential Diagnosis

• Bipolar Disorder
• ADHD
• Conduct Disorder
• PTSD
• PDD

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Schizophrenia Prognosis

• Good - higher IQ, precipitant

• Poor - early onset, neurologic abnormalities,
  negative symptoms

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Psychopharmacology for Children and Adolescents

• Stimulants

• Antidepressants

• Mood stabilizers

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Psychopharmacology for Children and Adolescents
(Contd)

• Neuroleptics

• Adrenergic agonists

• Minor tranquilizers

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Attention Deficit Disorder Decision Tree
Impulsivity
Inattention
Methylphenidate
bupropion clonidine tricyclic
SSRI
Dextroamphetamine
Combinations Mood Stabilizers Buspar Beta blockers
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Stimulants

• Methylphenidate (Ritalin)
• Dextroamphetamine (Dexedrine)
• Adderall
• Magnesium pemoline (Cylert)

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Antidepressants for ADHD

• Fluoxetine (Prozac)
• Bupropion (Wellbutrin)
• Venlafaxine (Effexor)
• Tricyclics

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Other Treatments for ADHD

• Alpha-adrenergic stimulating agents
• Beta-adrenergic blocking agents

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Depression Decision Tree
Noradrenergic
Serotoninergic
Bupropion Venlafaxine Remeron
Stimulants B-blockers
SSRI BuSpar
Valproate Carbamazepine Lithium
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Treatment of Psychosis

• Atypical neuroleptics
• Risperidone
• Olanzapine
• Quetiapine
• Mood stabilizers
• Valproate
• Lithium
• Carbamazepine

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Ideally, one would like to practice medicine
without having to bother with actual patients.
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Other Treatment Modalities for Neurodevelopmental
Disorders

• Social skills training
• Stress management
• Cognitive-Behavioral Treatment (CBT)
• School Accommodation
• Specialized neuropsychological approaches
• Family structure and support
• Psychotherapy

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