Let's get physical: an audit of medical practice in first episode psychosis.
OBJECTIVE
To assess aspects of medical examination, diagnosis and side-effect monitoring, and to consider the role of routine investigations in this group as recommended by national guidelines.


METHODS
A retrospective file audit was performed on young people presenting with first episode psychosis (n = 117) over 12 months of treatment contact.


RESULTS
Diagnoses were: first episode psychosis (43%), schizophrenia (16%), drug-induced psychosis (12%), affective psychosis (13%) and brief reactive psychosis (2%). Only four of the 52 (8%) subjects undergoing neuroimaging had any abnormality, with only two of these requiring referral. Three of the 33 (9%) electroencephalograms were obviously abnormal, but without epileptiform activity. There was little documentation of the assessment of involuntary movements (4% of sample) or weight (15% of sample).


CONCLUSIONS
The low rates of clinically important abnormal findings in computed tomography/magnetic resonance imaging and electroencephalogram re-open debate about the need for routine neuroimaging and electrophysiology in this population.
McKay
Diana
D
drdrm@mac.com
Gorrell
Jo
J
Cornish
Alison
A
Tennant
Chris
C
Rosen
Alan
A
Moss
Beverley
B
Nash
Louise
L
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D003156:Community Mental Health Services; D003937:Diagnosis, Differential; D016903:Drug Monitoring; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008485:Medical Audit; D009517:New South Wales; D010343:Patient Admission; D017410:Practice Guidelines as Topic; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D014150:Antipsychotic Agents