Psychosis
A practical guide to new-onset psychotic symptoms in youth, including differential diagnosis, red flags, referral, and initial treatment framing.
Quick Summary
- New-onset psychotic symptoms in youth require a broad psychiatric, substance-related, and medical differential.
- Substance-induced psychosis is often more common than primary psychotic illness in acute settings.
- Developmental context and reality testing matter when interpreting unusual perceptions or beliefs.
- Red flags include suicidality, severe aggression, catatonia, medical instability, and very young age.
- Early referral and shorter duration of untreated psychosis are associated with better outcomes.
- Primary care and consult teams play an important role in recognition, family education, and linkage to treatment.
Resources
Practice Questions
- What features make you worry that a youth with psychotic symptoms needs urgent medical or psychiatric escalation?
- How would you distinguish a primary psychotic disorder from substance-induced or medically secondary psychosis in an initial evaluation?
Archived Teaching
Past teaching materials related to this topic will appear here as resources, not as a separate site section.