First Episode Psychosis Medical Workup

Acute medical workup for new‐onset psychosis in children and adolescents: A retrospective cohort

“…The first episode of psychosis in youth is not always a medical emergency. In some cases, symptoms such as a fever or focal neurological findings raise concern for an acute process, like infection or intracranial lesion; these should be investigated promptly as they represent a possible reversible medical cause of psychotic symptoms 2–5 . Our findings suggest that in the absence of red flags, medical workup can likely be done in a variety of settings, including outpatient, and might be safely limited to basic laboratory testing.…”

“…[2][3][4][5] Our findings suggest that in the absence of red flags, medical workup can likely be done in a variety of settings, including outpatient, and might be safely limited to basic laboratory testing. When appropriately staffed and funded, outpatient psychiatric programs like early psychosis clinics sponsored by the Substance Abuse and Mental Health Services Administration, are optimized to coordinate this workup and track patients longitudinally.…”

“…Benjamin et al 3 recommend routine laboratory tests. Other groups, including Skikic and Arriola, 4 recommend additional testing, including electroencephalogram (EEG) and baseline/monitoring labs in case antipsychotics are started. Although neuroimaging is commonly performed, routine neuroimaging in children and adolescents with new‐onset psychotic symptoms lacks robust evidence 7–9 .…”

“…Recommendations for medical workup of psychosis vary. [1][2][3][4][5] Since psychotic disorders are rarely present in youth, children and adolescents with new psychosis symptoms frequently receive medical evaluation. 6 Evaluating psychotic symptoms while minimizing risks associated with medical testing is challenging.…”

“…Recommendations for medical workup of psychosis vary 1–5 . Since psychotic disorders are rarely present in youth, children and adolescents with new psychosis symptoms frequently receive medical evaluation 6 .…”