Section - Quick Takes

05. Predictors of Diagnostic Stability in Brief Psychotic Disorders: Findings From a 3-Year Longitudinal Study

Published on November 1, 2021 Expired on April 1, 2025

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Data on recurrence of psychosis after a first brief episode (non-affective, non-substance use) are too variable to support more than a prediction that recurrence is a clear risk, especially over a longer (e.g. 6-year) period.

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Text version

Here’s your next admission, and the question will be: What’s the prognosis with no treatment? Your patient, Ms. Rodriguez, is a 30-year-old psychiatric inpatient with no prior psychiatric history who presented with delusions and auditory hallucinations. These symptoms began several days prior to admission, and she has no history of substance use and a negative urine toxicology screen. Her sister, an apparently reliable historian, is quite certain that Ms. Rodriguez has not had any affective disorder, and she is not in a postpartum state. A TSH is 2.0, and she is not taking any medications.

Hi! Jim Phelps here for the Psychopharmacology Institute. Ms. Rodriguez is one of the 5% to 10% of patients with a first-episode psychosis that is not substance induced, not affective, nor caused by a medical condition, such as thyroid abnormalities, steroid treatment, or more rare conditions, such as anti-NMDA receptor autoimmune encephalitis. Ms. Rodriguez is

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Learning Objectives:

After completing this activity, the learner will be able to:

Examine the sensitivity and specificity of multiple symptoms and labs used in the diagnosis of myocarditis among patients taking clozapine.
Evaluate the evidence for the use of prophylactic fluoxetine after a stroke for improving neurologic outcomes and recovery rates as well as preventing depression.
Assess the relative efficacy and adverse event potential of methylphenidate vs alpha-adrenergic agonists in preschool children with ADHD.
Review recent research regarding the effect of antidepressant initiation on suicidal ideation.
Examine recent research regarding prognostic factors for recurrence for patients with first-episode psychosis.

Original Release Date: November 1, 2021

Review and Re-release Date: March 1, 2024

Expiration Date: April 1, 2025

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.