Psychiatrists are often left with the dilemma of which investigations to order in adolescents presenting with a first episode of psychosis. Blood work, urine studies, and neuroimaging studies were tracked in 13 adolescents admitted with a diagnosis of first-episode psychosis over a 13-month period to the Children’s Hospital of Eastern Ontario. Variation was found in the amount of investigation ordered: 85% of patients received a drug screen; 54% a CT scan; 8% an MRI; 92% a CBC with differential; 92% electrolytes. Abnormalities of CT scans were detected in 2 patients (29%); in neither case did the result lead to a diagnosis of brain-lesion-related psychosis, nor did it affect the clinical care of the patient. This study highlights the need to develop clinical practice-guidelines for the workup of first-episode psychosis in adolescents.
Shefrin, Allan M.D. (PGY2); Puddester, Derek M.D.; Greenham, Stephanie Ph.D.; Bisnaire, Lise Ph.D.; and Gandy, Hazen M.D.
"What Investigations Are Ordered in Patients with First-episode Psychosis?,"
Jefferson Journal of Psychiatry: Vol. 20
, Article 2.
Available at: http://jdc.jefferson.edu/jeffjpsychiatry/vol20/iss1/2