Phenomenology and epidemiology of childhood psychiatric disorders that may necessitate treatment with atypical antipsychotics.

Children and adolescents commonly present to clinical settings with more severe psychopathology than previously recognized. Physicians evaluating children may be confronted with clinical manifestations of early-onset schizophrenia, including command hallucinations and delusional thinking, severe irritability and suicidality associated with juvenile-onset bipolar disorder, or the severe aggression of a child with a pervasive developmental disorder. In these as well as other clinical situations, the potential risks and benefits of treatment with atypical antipsychotics should be considered. In this article, we summarize the clinical manifestations of psychiatric disorders in children and adolescents, with particular attention to the disorders for which the benefits of prescribing an atypical antipsychotic may outweigh the potential risks. We also describe the differences in the clinical presentation of these disorders between youth and adults.