Acute medical workup for new-onset psychosis in children and adolescents: A retrospective cohort.

TitleAcute medical workup for new-onset psychosis in children and adolescents: A retrospective cohort.
Publication TypeJournal Article
Year of Publication2022
AuthorsMuhrer E, Moxam A, Dunn M, Rosen A, Taylor JH, Camacho P, Bowden C, Worsley D, Doupnik SK
JournalJ Hosp Med
Date Published2022 Jul 13
ISSN1553-5606
Abstract

No consensus exists about which medical testing is indicated for youth with new-onset psychotic symptoms. We conducted a chart review of youths aged 7-21 years who were medically hospitalized for workup of new-onset psychotic symptoms from January 2017 through September 2020 in a free-standing children's hospital. The sample included 131 patients. At discharge, 129 (98.5%; 95% confidence interval [CI]: 94.5-99.8) were diagnosed with a primary psychiatric condition, 1 was diagnosed with levetiracetam-induced psychosis, and 1 with seronegative autoimmune encephalitis. Notably, 33 (25.2%; 95% CI: 18.0-33.5) had incidental findings unrelated to psychosis, 14 (10.7%; 95% CI: 6.0-17.3) had findings that required medical intervention but did not explain the psychosis, 12 (9.2%; 95% CI: 4.8-15.5) had a positive urine drug screen, and 4 (3.1%; 95% CI: 0.8-7.6) had a neurological exam consistent with conversion disorder. In conclusion, extensive medical testing in the acute setting for psychosis had a low yield for identifying medical etiologies of new-onset psychotic symptoms.

DOI10.1002/jhm.12905
Alternate JournalJ Hosp Med
PubMed ID35822507
Grant ListK23MH115162 / NH / NIH HHS / United States
KL2TR001879 / TR / NCATS NIH HHS / United States