Let's get physical: an audit of medical practice in first episode psychosis

Australas Psychiatry. 2006 Jun;14(2):146-9. doi: 10.1080/j.1440-1665.2006.02277.x.

Abstract

Objectives: To assess aspects of medical examination, diagnosis and side-effect monitoring, and to consider the role of routine investigations in this group as recommended by national guidelines.

Method: A retrospective file audit was performed on young people presenting with first episode psychosis (n = 117) over 12 months of treatment contact.

Results: Diagnoses were: first episode psychosis (43%), schizophrenia (16%), drug-induced psychosis (12%), affective psychosis (13%) and brief reactive psychosis (2%). Only four of the 52 (8%) subjects undergoing neuroimaging had any abnormality, with only two of these requiring referral. Three of the 33 (9%) electroencephalograms were obviously abnormal, but without epileptiform activity. There was little documentation of the assessment of involuntary movements (4% of sample) or weight (15% of sample).

Conclusions: The low rates of clinically important abnormal findings in computed tomography/magnetic resonance imaging and electroencephalogram re-open debate about the need for routine neuroimaging and electrophysiology in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Brain / pathology
  • Community Mental Health Services
  • Diagnosis, Differential
  • Drug Monitoring
  • Electroencephalography
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Medical Audit*
  • New South Wales
  • Patient Admission
  • Practice Guidelines as Topic
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / etiology
  • Risk Factors
  • Tomography, X-Ray Computed

Substances

  • Antipsychotic Agents