DIAGNOSTIC UTILITY OF ENDOCRINE AND NEUROIMAGING SCREENING-TESTS IN FIRST-ONSET ADOLESCENT PSYCHOSIS

Objective: To determine the diagnostic utility of endocrine and neuroi maging screening tests in first-onset adolescent psychosis. Method: 11 1 consecutively admitted adolescents (aged 13 through 19 years) who pr esented with a first-onset psychosis and who had an unremarkable medic al history and normal physical examination were given a battery of end ocrine and neuroimaging screening tests. Diagnostic utility of a scree ning test was defined as an abnormal result (a positive test) that eit her led to a previously unknown or unsuspected medical diagnosis or pl ayed an important role in the clinical care of the patient. Results: 1 5.4% of the endocrine screening tests and 11.0% of the neuroimaging sc reening tests were identified as positive. However, no endocrine and n o neuroimaging tests met criteria for diagnostic utility. The direct c ost of this screening battery was $636.95 per patient. Conclusion: Rou tine endocrine and neuroimaging screening tests in first-onset adolesc ent psychosis provide no diagnostic utility and are not cost-effective . Selective use of appropriate endocrine and neuroimaging diagnostic t ests in populations with symptoms suggestive of organic disorders shou ld replace routine screening procedures.