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First Episode Psychosis

I went to Psychiatry Grand Rounds this week at UMass Medical School. Eduardo Caussade-Rodriguez, MD, gave a talk entitled You Want Me to Order What? The Medical Workup for First-Episode Psychosis. He talked about all the tests psychiatrists routinely order for new patients with psychotic symptoms. They include a bunch of blood and other bodily fluid tests, an EEG, MRI or CT scan, and on. They are all very expensive. And they are all designed to rule out other causes for the psychosis rather than Schizophrenia, something you’d rather not be diagnosed with.

I remember all these tests. They took a long time. My insurance company paid a pile of money to get them done.

Although those tests must be important, I now wonder why they spend so much time and money trying to find out if the psychosis is caused by something other than what they hope it isn’t, rather than working on fixing what it probably is.

I now wonder if it might have been more productive if we had spent those resources talking to the psychiatrist, instead.


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