Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- idade superior a 18 anos
- ao menos 1 sintoma psicótico positivo com duração >1 dia mas <1 mês
- sintomas não decorrentes do uso de substâncias
- sintomas não decorrentes de condição médica
Other diagnostic factors
- grávida ou até 4 semanas pós-parto
- estresse e trauma recentes
Risk factors
- evento estressor significativo
- transtorno de personalidade
- história familiar de transtorno psicótico
- gravidez ou 4 semanas pós-parto
- sintomas psiquiátricos prévios em mulheres
- idade entre 35 e 45 anos
- mãe solteira
Diagnostic investigations
1st investigations to order
- teste de gravidez no soro (mulheres)
Investigations to consider
- eletrólitos
- ureia
- creatinina
- glicose
- TFHs
- testes da função tireoidiana (TFTs)
- sorologia para sífilis
- urinálise
- exame toxicológico de urina
- eletrocardiograma (ECG)
- tomografia computadorizada (TC) cranioencefálica
- ressonância nuclear magnética (RNM) cranioencefálica
Treatment algorithm
em condições de aceitar ou tolerar tratamento oral
recusa ou tem intolerância a tratamento oral
Contributors
Authors
Kimberly R. Warren, PhD
Associate Professor
Morgan State University
Department of Psychology
Baltimore
MD
Disclosures
KRW declares that she has no competing interests.
Elaine Weiner, MD
Assistant Professor
Outpatient Research Program
Department of Psychiatry
Maryland Psychiatric Research Center
University of Maryland
School of Medicine
Catonsville
MD
Disclosures
EW declares that she has no competing interests.
Deanna L. Kelly, PharmD
Associate Professor
Director
Treatment Research Program
Maryland Psychiatric Research Center
University of Maryland
School of Medicine
Department of Psychiatry
Catonsville
MD
Disclosures
DLK has served as a consultant for Alkermes and HLS Therapeutics.
Acknowledgements
Dr Kimberly Warren, Dr Elaine Weiner, and Dr Deanna Kelly would like to gratefully acknowledge Dr William R. Keller, a previous contributor to this topic.
Disclosures
WRK declares that he has no competing interests.
Peer reviewers
Joel Yager, MD
Professor
Department of Psychiatry
University of New Mexico School of Medicine
Albuquerque
NM
Disclosures
JY is an author of a reference cited in this topic.
Craig N. Sawchuk, PhD
Affiliate Assistant Professor
Department of Psychiatry and Behavioral Sciences
University of Washington Medical Center
Seattle
WA
Disclosures
CNS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Text revision. (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022.
Fusar-Poli P, Salazar de Pablo G, Rajkumar RP, et al. Diagnosis, prognosis, and treatment of brief psychotic episodes: a review and research agenda. Lancet Psychiatry. 2022 Jan;9(1):72-83. Abstract
Kane JM, Leucht S, Carpenter D, et al. Optimizing pharmacologic treatment of psychotic disorders: the expert consensus guideline series. J Clin Psychiatry. 2003;64(12 suppl):1-100.Full text Abstract
National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management. Mar 2014 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Esquizofrenia
- Transtorno delirante
- Transtorno depressivo maior com características psicóticas
More DifferentialsРекомендации
- Psychosis and schizophrenia in adults: prevention and management
- Optimizing pharmacologic treatment of psychotic disorder: the Expert Consensus Guideline Series
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