Article Text

Download PDFPDF
Fifteen-minute consultation: an approach to a child presenting to the emergency department with acute psychotic symptoms
  1. Anil Vasudev Israni,
  2. Sumant Kumar,
  3. Nahin Hussain
  1. Department of Paediatric Neurology, Leicester Royal Infirmary, Leicester, UK
  1. Correspondence to Dr Sumant Kumar, Department of Paediatric Neurology, Leicester Royal Infirmary, Leicester LE1 5WW, UK; drsumantsinha{at}


Presentation of a child in the A&E with altered behaviour including psychotic features is not unusual. New-onset psychotic symptoms in children pose a significant diagnostic challenge due to several reasons. First, primary psychotic conditions are uncommon in pre-pubertal children. Second, differentiating between delirium and psychosis can be difficult in children, more so in infants, toddlers and young children. Third, intervening and managing a secondary cause of psychosis can significantly optimise outcome. Prompt recognition of a possible underlying cause for a child’s psychotic behaviour is essential, and at the same time challenging, in the emergency department. This article attempts to present a systematic approach to a child with acute onset of psychotic symptoms in an emergency setting.

  • paediatric practice
  • paediatric neurology
  • acute psychosis
  • children
  • emergency

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.