title: Initial medical work-up of first-episode psychosis: a conceptual review.
abstract: OBJECTIVE
  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.affiliation: Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, Harvard Medical School, 25 Staniford Street, Boston, MA 02114, USA. ofreudenreich@partners.org
authors.forename: Oliver
authors.initials: O
authors.lastname: Freudenreich
authors.forename: S Charles
authors.initials: SC
authors.lastname: Schulz
authors.forename: Donald C
authors.initials: DC
authors.lastname: Goff
mesh_terms: D001921:Brain / Q000473:pathology / Q000503:physiopathology; D019411:Clinical Laboratory Techniques; D015897:Comorbidity; D003937:Diagnosis, Differential; D004569:Electroencephalography; D006801:Humans; D008279:Magnetic Resonance Imaging; D017410:Practice Guidelines as Topic; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed