Abstract：
Early onset of schizophrenia (before the age of 18 years) is associated with a higher risk of delayed or missed diagnosis, more severe course of the disease, and an increased susceptibility to adverse reactions to antipsychotic drugs. The objective of this paper is to present the recommendations for the diagnostic and therapeutic management of patients with early-onset schizophrenia, developed on the basis of a literature review and a consensus of a group of experts working with schizophrenia therapy. The formal criteria that must be met to diagnose schizophrenia are the same for children and adults. Early-onset schizophrenia must be thoroughly differentiated from uni - or bipolar affective disorder, autism-spectrum disorders (ASDs) and anxiety disorder. Diagnostic assessment for psychotic disorders is also necessary in the case of abnormal, destructive or aggressive behaviour, or self-harm. The mainstay of schizophrenia treatment is pharmacological therapy, which is used in the treatment of acute episodes and in maintenance treatment - prevention of relapses. However, the use of pharmacological interventions in children and adolescents only to reduce the risk of psychosis development is not justified. Antipsychotic agents significantly differ by their tolerance profile and clinical efficacy. Second-generation antipsychotic agents approved for the treatment of early-onset schizophrenia - aripiprazole, lurasidone and paliperidone - enable its effective and safe treatment. The necessary complement to pharmacological therapy is non-pharmacological interventions that should be adapted to the patient\'s age, cognitive abilities, disease stage and the needs of the whole family.
摘要：
精神分裂症的早期发病（18岁之前）与延迟或漏诊的高风险相关，更严重的病程，以及抗精神病药物不良反应的易感性增加。本文的目的是提出对早发性精神分裂症患者的诊断和治疗管理的建议。在文献综述和一组致力于精神分裂症治疗的专家达成共识的基础上发展起来的。诊断精神分裂症必须符合的正式标准对于儿童和成人是相同的。早发性精神分裂症必须与单发或双相情感障碍彻底区分，自闭症谱系障碍（ASDs）和焦虑症。在异常的情况下，对精神障碍的诊断评估也是必要的，破坏性或攻击性行为，或自我伤害。精神分裂症治疗的主体是药物治疗,用于治疗急性发作和维持治疗-预防复发。然而,仅在儿童和青少年中使用药物干预措施来降低精神病发展的风险是不合理的.抗精神病药物的耐受性和临床疗效显着不同。第二代抗精神病药批准用于治疗早发性精神分裂症-阿立哌唑，lurasidone和帕潘立酮-使其有效和安全的治疗。药物治疗的必要补充是非药物干预措施，应适应患者的年龄，认知能力,疾病阶段和整个家庭的需求。
