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 psychopathologythan previously recognized. Physicians evaluating children may be confronted with clinical manifestationsof early-onset schizophrenia, including command hallucinations and delusional thinking, severeirritability and suicidality associated with juvenile-onset bipolar disorder, or the severe aggressionof 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 thisarticle, 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 antipsychoticmay outweigh the potential risks. We also describe the differences in the clinical presentation of thesedisorders between youth and adults.