First Episode Psychosis Medical Workup: Evidence-Informed Recommendations and Introduction to a Clinically Guided Approach

Maja Skikic; Jose Alberto Arriola

doi:10.1016/j.chc.2019.08.010

First Episode Psychosis Medical Workup: Evidence-Informed Recommendations and Introduction to a Clinically Guided Approach

Child Adolesc Psychiatr Clin N Am. 2020 Jan;29(1):15-28. doi: 10.1016/j.chc.2019.08.010.

Authors

Maja Skikic¹, Jose Alberto Arriola²

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA. Electronic address: maja.skikic@vumc.org.
² Department of Psychiatry and Behavioral Sciences, Consult-Liaison Psychiatry, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.

PMID: 31708044
DOI: 10.1016/j.chc.2019.08.010

Abstract

Evaluating the patient with first episode psychosis (FEP) requires a careful assessment that includes a thorough history, examination, and workup. This begins with a thoughtful consideration of the differential diagnoses and is followed and supported by laboratory, encephalographic, and imaging studies where appropriate. This article presents some of the diagnostic considerations for a patient presenting with psychosis with an emphasis on the secondary causes and proposes a tiered approach to the workup of FEP that is clinically guided.

Keywords: First episode psychosis; Medical etiologies; Psychosis laboratories; Psychosis workup; Secondary psychosis.

Publication types

Review

MeSH terms

Adolescent
Adult
Child
Humans
Middle Aged
Practice Guidelines as Topic*
Psychotic Disorders / diagnosis*
Psychotic Disorders / etiology*
Young Adult