Jardri Renaud, Delion Pierre, Goëb Jean-Louis
Service de psychiatrie infanto-juvénile, Hôpital Fontan, Laboratoire de neurosciences fonctionnelles et pathologies, CNRS UMR-8160, Université Lille Nord de France, CHRU de Lille, F-59037 Lille Cedex, France.
Presse Med. 2010 Apr;39(4):420-30. doi: 10.1016/j.lpm.2009.09.010. Epub 2009 Nov 10.
Hallucinations are a common symptom in pediatric populations. Because spontaneous rapid recovery often occurs, routine medication with antipsychotic drugs should be avoided. An adequate initial etiological assessment requires a medical examination, a psychiatric interview, and a meeting with key adult informants. Laboratory testing and imaging may also be useful. The risk of self-injury or harming others must be systematically assessed and should determine the choice between prescribing a nonspecific anxiolytic medication or hospitalizing the child. Treatment should combine psychotherapy and psychoeducation, and antipsychotics should be given in case of prodromal psychotic presentation. In the years to come, randomized controlled trials should define the exact role that repetitive transcranial magnetic stimulation might play as a treatment of hallucinations in children and adolescents.
幻觉是儿科人群中的常见症状。由于常常会自发快速康复,应避免常规使用抗精神病药物。充分的初始病因评估需要进行医学检查、精神科访谈以及与主要成年知情者会面。实验室检查和影像学检查也可能有用。必须系统评估自伤或伤害他人的风险,这应决定是开具非特异性抗焦虑药物还是让孩子住院。治疗应结合心理治疗和心理教育,对于前驱性精神病表现的情况应给予抗精神病药物。在未来几年,随机对照试验应明确重复经颅磁刺激作为儿童和青少年幻觉治疗方法的确切作用。