Additional characteristics also help distinguish childhood-onset schizophrenia from the adolescent / young adult form (1): More severe symptoms A strong family history Increased prevalence of genetic abnormalities, developmental abnormalities (eg, pervasive developmental disorder, intellectual disability), and motor abnormalities Increased prevalence of premorbid social difficulties Insidious onset Cognitive deterioration Neuroanatomic changes (progressive loss of cortical gray matter volume, increase in ventricular volume) Sudden-onset psychosis in young children should always be treated as a medical emergency with a thorough medical assessment to search for a physiologic cause of the mental status change; these causes include (2) the following: Therapeutic drugs (eg, stimulants, corticosteroids, anticholinergics) Recreational drugs (eg, cannabis) Central nervous system (CNS) disorders, including infection (viral, bacterial, parasitic), tumors, demyelinating diseases, injury, seizures, or migraines Autoimmune disorders (eg, anti-NMDA [N - methyl - d - aspartate] receptor encephalitis [3], SLE) Endocrinopathies (eg, hyperthyroidism, hypocortisolemia) Sleep disorders Metabolic disorders (porphyria, Wilson disease, GM2 gangliosidosis) Lysosomal storage diseases Nutritional deficiencies (magnesium and vitamins A, D, B1, B3, B12) Chromosomal abnormalities (22.11q, XXY, XO, fragile X, Prader-Willi, Fahr's Dis) COVID-19 (4 - 7) Recent research indicates that there is an increased risk of developing certain psychotic disorders (namely, bipolar disorder and schizophrenia) among adolescents who use cannabis products containing tetrahydrocannabinol (THC; 8).