For example, there must be clear consciousness, thus eliminating febrile, delirious states or the influence of psychoactive substances. In the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Episode Version (K-SADS) (2), additional parameters regarding hallucinations are specified. Hallucinations can be defined as perceptions in the absence of identifiable external stimuli, excluding eidetic images and imaginary companions. The first clinical task in evaluating children and adolescents is to sort out the most serious and worrisome hallucinations from those that are less pathological. In children, however, hallucinations can be part of normal development or can be associated with nonpsychotic psychopathology, psychosocial adversity, or a physical illness (1). Hallucinations, particularly as described in the adult psychiatric literature, have been viewed as synonymous with psychosis and as harbingers of serious psychopathology. Should the hallucinations in these children be equated with psychosis? What is the differential diagnosis of hallucinations in children, and what is the prognosis for children with hallucinations? What interventions are indicated in the psychiatric emergency service for children who present with hallucinations? Her mother said that the girl is also hyperactive and restless at school. She admitted that she has tactile hallucinations and obsessive thoughts of cleanliness. The patient appeared to be anxious and to have poor control of her behavior and low tolerance for frustration. The mother, the patient, and a 12-year-old sister have been living in a shelter. A 7-year-old girl who was evaluated 2 days earlier at a children"s hospital and medically cleared was brought to the psychiatric emergency service by her mother, who reported that her daughter claims to feel bugs and mice crawling over her and that during those episodes she screams and is inconsolable. He admitted to having an explosive temper when “people mess with me,” and he said that he sometimes “goes crazy.” He said that he often thinks of his deceased grandmother. ![]() The emergency service intake worker reported that the boy claimed to hear voices that tell him to do bad things and claimed to see ghosts. of oral methylphenidate, which was prescribed by a primary care doctor. He was reported to have recently kicked his pregnant sister and vandalized the house of a neighbor he dislikes. His mother described him as disrespectful to her and other adults with episodes of cursing and screaming that last for hours. A 9-year-old boy with escalating behavioral problems was brought to a psychiatric emergency service.
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