Specialized consultation for suspected recent-onset schizophrenia: Diagnostic clarity and the distorting impact of anxiety and reported auditory hallucinations

Chelsey Coulter, Krista K. Baker, Russell L. Margolis

Research output: Contribution to journalArticle

Abstract

Early detection of psychotic disorders is now recognized as vital in reducing dysfunction, morbidity, and mortality. However, making the diagnosis of a psychotic disorder, especially earlier in the course of disease, can be challenging, and an incorrect diagnosis of a psychotic disorder may also have significant consequences. We therefore, conducted a retroactive chart review of 78 patients referred to a specialty early psychosis consultation clinic to examine the role of specialty clinics in clarifying the diagnosis of early psychosis, especially potential schizophrenia. Of the 78 patients, 43 (55%) had a primary diagnosis at referral of a schizophrenia spectrum disorder. The primary diagnosis in the consultation clinic was different in 22 (51%) of these 43 cases, and 18 (42%) of these patients were not diagnosed with any form of primary psychotic disorder. These patients were more likely to report anxiety and less likely to report thought disorder than patients with a consultation diagnosis of schizophrenia or schizoaffective disorder. Clinicians may therefore overdiagnose schizophrenia, demonstrating the value of second opinions from clinics specializing in the diagnosis of recent-onset psychosis.

Original languageEnglish (US)
Pages (from-to)76-81
Number of pages6
JournalJournal of psychiatric practice
Volume25
Issue number2
DOIs
StatePublished - Mar 2019

Keywords

  • Consultation
  • Diagnosis
  • Hallucinations
  • Psychosis
  • Recent onset
  • Schizophrenia
  • Second opinion

ASJC Scopus subject areas

  • Psychiatry and Mental health

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