Early Detection and Treatment Options for Psychosis in Transition from Childhood to Adolescence: A Review About Three Decades of Psychiatric Clinical Experience

In the 1980s, we worked with young adults suffering from psychosis (often with drug abuse beforehand) and we had limited drugs and no concept whatsoever (Zentrum für Psychiatrie Herten, Germany). We started with a systemic therapy concept in a ward specialized in psychotic patients from age 18 to 30 and a training (Brenner Program) to guide them into a healthier way of living. There had been no experience in combining individual therapies with education for the patient and his/her parents and siblings in adult psychiatry. The limitations of adult psychiatry in those times made me switch to child and adolescent psychiatry, which included family therapy to get earlier diagnoses and prevent the unsatisfactory outcome, that we had to handle in adult psychiatry at that time. This chapter includes several case reports and also deals with early diagnosis and preventive treatment, especially when several siblings are affected. Plus, there are references to a Canadian and German study regarding psychosis and drug abuse. Another item is the difficulty of transition, i.e., how to transfer child/adolescent psychiatric treatment into a manageable concept for young adults. It must be considered that the cooperation between the child/adolescent clinic in Germany is allowed to treat up to age 21 and the psychiatric clinician for adults, who treats patients from age 18 onwards.