[Hallucinations in children and adolescents: diagnostic and treatment strategies]

Abstract

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.