Diagnostic utility of endocrine and neuroimaging screening tests in first-onset adolescent psychosis.
OBJECTIVE
To determine the diagnostic utility of endocrine and neuroimaging screening tests in first-onset adolescent psychosis.


METHODS
111 consecutively admitted adolescents (aged 13 through 19 years) who presented with a first-onset psychosis and who had an unremarkable medical history and normal physical examination were given a battery of endocrine and neuroimaging screening tests. Diagnostic utility of a screening test was defined as an abnormal result (a positive test) that either led to a previously unknown or unsuspected medical diagnosis or played an important role in the clinical care of the patient.


RESULTS
15.4% of the endocrine screening tests and 11.0% of the neuroimaging screening tests were identified as positive. However, no endocrine and no neuroimaging tests met criteria for diagnostic utility. The direct cost of this screening battery was $636.95 per patient.


CONCLUSIONS
Routine endocrine and neuroimaging screening tests in first-onset adolescent psychosis provide no diagnostic utility and are not cost-effective. Selective use of appropriate endocrine and neuroimaging diagnostic tests in populations with symptoms suggestive of organic disorders should replace routine screening procedures.
Adams
M
M
Department of Psychiatry, University of Toronto, Canada.
Kutcher
S
S
Antoniw
E
E
Bird
D
D
D000293:Adolescent; D001921:Brain / Q000473:pathology; D003362:Cost-Benefit Analysis; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000191:economics; D004700:Endocrine System Diseases / Q000175:diagnosis* / Q000191:economics / Q000523:psychology; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000191:economics / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000191:economics / Q000209:etiology* / Q000523:psychology
D006728:Hormones