Oliver Freudenreich1, S Charles Schulz, Donald C Goff. 1. Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, Harvard Medical School, 25 Staniford Street, Boston, MA 02114, USA. ofreudenreich@partners.org
Abstract
AIM: To help clinicians carry out a comprehensive, medical diagnostic assessment in first-episode patients who are suspected of developing schizophrenia. METHODS: Conceptual review of the published work with emphasis on the diagnostic goals of excluding medical causes of psychosis and establishing a medical baseline. RESULTS: There is no agreed-upon standard for the initial medical work-up of first-episode cases. Excluding secondary causes of schizophrenia requires consideration of likelihood of disease; laboratory test performance; and relevance of positive test results. CONCLUSIONS: We propose a medical work-up for first-episode psychosis that combines: (i) broad screening; (ii) exclusion of specific diseases informed by treatability and epidemiology; and (iii) medical baseline measures.
AIM: To help clinicians carry out a comprehensive, medical diagnostic assessment in first-episode patients who are suspected of developing schizophrenia. METHODS: Conceptual review of the published work with emphasis on the diagnostic goals of excluding medical causes of psychosis and establishing a medical baseline. RESULTS: There is no agreed-upon standard for the initial medical work-up of first-episode cases. Excluding secondary causes of schizophrenia requires consideration of likelihood of disease; laboratory test performance; and relevance of positive test results. CONCLUSIONS: We propose a medical work-up for first-episode psychosis that combines: (i) broad screening; (ii) exclusion of specific diseases informed by treatability and epidemiology; and (iii) medical baseline measures.
Authors: Matcheri S Keshavan; Guusje Collin; Synthia Guimond; Sinead Kelly; Konasale M Prasad; Paulo Lizano Journal: Neuroimaging Clin N Am Date: 2019-11-11 Impact factor: 2.264