First Presentation with Psychotic Symptoms to the Emergency Department

The Dual Burden of HIV Infection and First-Episode Psychosis in Africa

“…Substance use in study participants was reported on in four of the studies. Etlouba et al (2018) showed illicit substance use in 51 patients (32.1%), with cannabis and alcohol being the most common. The authors stratified patients into three groups, and reported cannabis use in eight patients (15.7%) in the group where psychosis was due to an underlying medical condition, and in four (7.8%) in the group of other psychotic disorders (OPD).…”

“…The studies were published between 2005 and 2018, of which four were conducted in SA (Etlouba et al, 2018;Mashaphu and Mkize, 2007;Säll et al, 2009;Uys, 2013) and three in Uganda (Maling et al, 2011;Nakasujja et al, 2012;Petrushkin et al, 2005). Five studies obtained data on FEP within a heterogeneous group of psychiatric illnesses (Maling et al, 2011;Nakasujja et al, 2012;Petrushkin et al, 2005;Säll et al, 2009;Uys, 2013), whereas the remainder recruited patients with FEP only (Etlouba et al, 2018;Mashaphu and Mkize, 2007). Nakasujja et al (2012) acknowledged study funding by Makerere University-Swedish International Development Cooperation Agency/ Department for Research Cooperation co-operation grant.…”

“…There was a male preponderance in the FEP study samples by Etlouba et al (2018) (mean, 95; F = 64) and Mashaphu and Mkize (2007). In the study by Uys (2013), the selection criteria were limited to female participants, whereas only male participants were recruited by Säll et al (2009).…”

“…The nature of psychotic symptoms in the FEP participants was described in two studies. In the study by Etlouba et al (2018), symptoms of all the patients (HIV infected and HIV uninfected) with FEP were described, but the authors did not compare the symptoms of the HIV-infected and noninfected groups specifically. Visual hallucinations were the most common psychotic symptom in the FEP group with underlying medical conditions (56.3%, n = 49) and the substance-induced psychotic disorder group (75.7%, n = 28).…”

Medical evaluation of psychotic symptoms in children and adolescents: Key approaches

“…It is also important to note that due to the structure of emergency departments, psychotic patients are often placed in an unmonitored bed, therefore possibly missing time‐dependent conditions requiring emergent intervention that might be captured with monitoring (e.g., meningitis, sepsis, subarachnoid hemorrhage; Etlouba et al, 2018) As this is often a necessary step for patient and staff safety, this is a risk that should likely only be taken after some degree of history‐taking, physical exam, and laboratory testing is already done. If this basic workup is negative, it is far less likely for the cause of psychosis to be medical in nature.…”