Psychoses à l'adolescence

Abstract

Psychosis is a major concern for adolescent-specialized psychiatrists who face great difficulties in making diagnosis in case of acute or torpid symptomatology since at this age, such symptoms are not systematically correlated with a specific mental disorder. This symptomatology is relatively frequent as a polymorph expression of psychic suffering due to adolescence process. Adolescence is a period characterized by many deep internal and external changes, and it is also the preferential age period for the onset of most chronic mental disorders. At their beginning, most of these disorders have not yet the typical recognizable form they will have latter on, allowing at that time easier diagnosis. More than at other life periods, the clinician has to go beyond the descriptive symptomatology to find out the underlying psychopathological organisation that may be more informative on the observed disorder in terms of diagnosis and prognosis, with the awareness that schizophrenia begins frequently at this age. Similarly, we should not forget that this age corresponds also with the onset of mood disorders, often associated with psychotic positive symptoms that may lead to misdiagnosis. We should also distinguish, among pre-morbid symptoms, vulnerability factors or prodromal manifestations that induce important consequences in terms of therapeutic strategies.