Early-onset Psychotic Disorders

This unit is integrated into the Programme of Specific Attention to Early Psychotic Disorders (PAE-TPI), part of the Master Plan on Mental Health and Addictions (PDSMiA) from the Generalitat de Catalunya, and it offers multidisciplinary care through the Primary Care Network for Severe Mental Disorders.

From this unit, created in 2006, we work as per the protocol established in the SJD mental health network, coordinating with the following entities: Child and Adolescent Mental Health Centre (CSMIJ), Day Hospitals, Specialist Treatment Units, the ITAKA Acute Hospitalisation Unit, and Juvenile Psychiatric Emergency Care. In this way, we can ensure an equally comprehensive assessment, diagnosis and treatment process for patients with psychotic disorders or those at high risk of psychosis (categorised as Clinical High Risk).

General objectives of the unit:

• To offer specialist care for psychiatric disorders included in the SJD service repertoire.
• To equalise the diagnostic and therapeutic processes within the SJD healthcare network.
• To identify patients with incipient psychotic symptoms so as to take preventive action.
• To assess highly complex cases and render diagnostic second opinions, as per the established functional plan.

Specialist interventions at the unit

Psychoeducational group for patients and family members

Psychoeducational treatment is aimed at patients who have exhibited their first psychotic episode. It is conducted at the SJD Barcelona Children's Hospital in Esplugues de Llobregat and adopts a collaborative, cognitive-behavioral format, based on the stress-vulnerability model.  

The aim is to provide tools and resources to family members so they can understand the difficulties associated with the symptoms of children with psychotic disorders, and to encourage healthier coping mechanisms, leading to a better prognosis and clinical course for the patient.  

Computerised cognitive stimulation therapy

Highly specialised treatment backed by solid evidence. It consists of 40 sessions, two per week: one in-person session and one remote online session, both lasting 45 minutes.

Pre/post assessment – Social skills group for patients and family members. The therapy is carried out at the SJD Barcelona Children's Hospital in Esplugues de Llobregat. 

Accessing the Early-onset Psychotic Disorders Unit

Families can access the Early-onset Psychotic Disorders Unit when their primary place of residence is in the Hospitalet de Llobregat area or in the Baix Llobregat, Alt Penedès, Vallès Occidental, Anoia or Garraf comarcas. Any other areas in Catalonia will have their own dedicated facility assigned by the Catalan Health Service.

Patients can be referred to the unit from any Child and Adolescent Mental Health Centre (CSMIJ) facility, from a Day Hospital, from a hospitalisation ward, or from any emergency psychiatric appointments of the SJD Barcelona Children's Hospital.

Admission criteria

• Children and adolescents under the age of 18.
• Presence of psychotic symptoms, including two or more of the following: delirium, hallucinations, nonsensical language, catatonic or disorganised behavior and negative symptoms, whether newly presenting or already diagnosed. The symptom must have been present for at least one week.

The importance of raising awareness in the wider population

As well as direct intervention for those affected by a psychotic disorder and their family members, it is also important to educate the wider population in order to reduce the stigma often associated with these types of severe mental disorders.

Understanding these disorders is the foundation for being able to bust myths and correct preconceived notions that can add to the suffering inherent to said disorders.

As such, with the aim of raising awareness, unit staff are collaborating on the SOM Mental Health 360 project—a project promoted by various centers implicated with the Hospitaller Order of Saint John of God—which boasts the involvement of dozens more entities in various areas of the field of mental health (associations, foundations, social entities, etc.).

Research and clinical trials

Staff from the Early-onset Psychotic Disorders Unit are involved in various national and international projects—both their own research and collaborative research—on children and adolescents that are exhibiting their first psychotic episode and those with Critical High Risk mental states. Research is conducted by the Child and Adolescent Mental Health Research Group at the SJD Research Institute (IRSJD).

This research covers from basic clinical aspects up to highly specialised technology (neuroimaging with Diffusion Tensor Imaging - DTI, basic psychology profiling with cognitive paradigms, etc.).

One of the most relevant lines of research is the investigation into psychosis risk markers to create early detection and intervention strategies for psychotic disorders, with the ultimate aim being to delay or to prevent these disorders.

As a result of this research, the unit has been able to produce various scientific publications within the framework of the Child and Adolescent Mental Health Research Group, and has participated in national and international symposiums on the matter.