Pediatric emergency medicine trisk 4196 4196
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TABLE 126.23
MEDICALLY VERSUS PSYCHIATRICALLY BASED PSYCHOSIS:
MAJOR DIFFERENTIATING FEATURES
Assessment feature
History
Nature of onset
Preillness history
Medically based
psychosis
Psychiatrically based
psychosis
Usually acute
Prior illness/drug use
Usually insidious
Prior psychiatric history
(self or family)
Medical evaluation
Vital signs
May be impaired
Level of consciousness May be impaired
Pathologic autonomic May be present
signs
Laboratory studies
May be abnormal
Mental status evaluation
Orientation
May be impaired
Recent memory
May be impaired
Cognitive/intellectual
May be impaired
functioning
Nature of hallucinations Usually not auditory
(e.g., visual, tactile)
Response to support
Often dramatic
and medication
Usually normal
Normal
Normal
Normal
Intact
Intact
Intact
Auditory
Often limited
Schizophrenia. Schizophrenia may present in adolescence occurring in 0.5%
of the population. It is equally common in male and female patients,
although males present at an earlier age; and is more prevalent among
patients who have family members with the disease. Schizophreniform
disorder denotes similar symptomatology that is present for less than 6
months. Symptoms of schizophrenia involve impairment of basic
