• Personality Disorders
• Child & Adolescent Psychiatry

Gaurav Kulkarni, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, presented the result of a case study analysis and literature review, suggesting an approach involving early intervention and more aggressive treatment to help prevent violence in adolescents experiencing paranoid delusions.

Paranoid delusions are exaggerated fears of others in a person's mind that may impair functioning at school and work and in personal relationships. The possibility exists that when anger escalates in the mind of an adolescent experiencing paranoid delusions it may manifest itself, at some point, into violent behavior.

The case report describes an adolescent homicide that could potentially have been prevented by providing earlier psychiatric care. The case involved a 16-year-old female with paranoid ideations that built until she killed her younger sister. Details of the case were modified from an actual case to protect confidentiality.

The researchers recommend an approach to help prevent crimes that focuses on early interventions and more aggressive treatment. Because the first medical professional who may become aware of problems is often a primary care provider, the treatment approach was developed to be useful to pediatricians, family practitioners, and other primary care providers.

The researchers suggest that the family should be educated about the child's paranoid ideation and associated aggressive behavior with a focus on improving the overall insight of the family and the patient about the psychosis. They also suggest clinicians gain more clinical history about the paranoia in order to help patients improve their reality testing.

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The editors would like to thank the many members of the American Psychiatric Association presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.

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