Psychosis Caused by a Somatic Condition: How to Make the Diagnosis? A Systematic Literature Review

Psychosis Caused by a Somatic Condition: How to Make the Diagnosis? A Systematic Literature Review

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Background: First episode of psychosis (FEP) is a clinical condition that usually occurs during adolescence or early adulthood and is often a sign of a future psychiatric disease.However, these symptoms are not specific, and psychosis can be caused by a physical disease in at least 5% of cases.Timely detection of these diseases, FIDGITS the first signs of which may appear in childhood, is of particular importance, as a curable treatment exists in most cases.However, there is no consensus in academic societies to offer recommendations for a comprehensive medical assessment to eliminate somatic causes.

Methods: We conducted a systematic literature search using a two-fold research strategy to: (1) identify physical diseases that can be differentially diagnosed for psychosis; and (2) determine the paraclinical exams allowing us to exclude these pathologies.Results: We identified 85 articles describing the autoimmune, metabolic, neurologic, infectious, and genetic differential diagnoses of psychosis.Clinical presentations are described, and a complete list of laboratory and imaging features required to identify and confirm these diseases is provided.Conclusion: This systematic review shows that most differential diagnoses of psychosis should be considered in the case of a FEP and could be identified by providing a systematic checkup with a laboratory test that includes ammonemia, antinuclear and anti-NMDA antibodies, and HIV testing; brain magnetic resonance imaging and lumbar puncture should be considered according to the clinical presentation.

Genetic research could be of interest to patients presenting with L-PROLINE physical or developmental symptoms associated with psychiatric manifestations.