To evaluate the medical workup of children and adolescents admitted for a first presentation of psychotic symptoms at a tertiary pediatric center over a 10-year period, highlighting the significance of accurate diagnosis.
Key Findings:
23.5% of patients were diagnosed with substance-/medication-induced or medically-associated psychosis, indicating a need for thorough evaluation.
Younger age, early onset psychosis (<13 years), and catatonia were more common in patients with secondary etiologies, suggesting distinct clinical features.
Prior subthreshold symptoms were more frequently documented among those with primary psychiatric disorders, emphasizing the importance of history.
Most investigations did not identify a secondary cause, but selected cases highlighted the importance of careful assessment in specific contexts.
Interpretation:
Targeted medical evaluation may be beneficial in pediatric psychosis, especially when clinical features suggest secondary causes, aiding clinical decision-making in tertiary settings and improving patient outcomes.
Limitations:
Retrospective design may limit the comprehensiveness of data and introduce biases.
Findings may not be generalizable beyond the studied tertiary center, necessitating further research in diverse settings.
Conclusion:
The study underscores the importance of thorough medical evaluation in pediatric patients presenting with psychotic symptoms to differentiate between primary and secondary causes, which is crucial for effective treatment.
