No access
Brief Reports
Published Online: 28 June 2024

Second Opinions for Diagnoses of Psychotic Disorders: Delivering Stage-Specific Recommendations

Carol Lim, M.D., M.P.H. [email protected], Abigail L. Donovan, M.D., Sophie Freudenreich, Corinne Cather, Ph.D., Sarah Maclaurin, P.M.H.N.P., and Oliver Freudenreich, M.D., F.A.C.L.P.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 10
https://doi.org/10.1176/appi.ps.20230623
Track CitationsAdd to favorites
Get Access

Abstract

Objective:

The impact of obtaining second-opinion consultations on diagnoses of schizophrenia spectrum disorders was evaluated.

Methods:

A retrospective chart review was conducted for 177 patients referred to a psychosis consultation service at an academic medical center from January 1, 2017, to October 1, 2023; these consultations aimed to clarify a diagnosis of psychosis. Diagnoses made before and after consultations were compared, and treatment recommendations resulting from the consultation visit were summarized.

Results:

Among patients without a preconsultation diagnosis of schizophrenia, 28% (N=28 of 100) received a postconsultation diagnosis of schizophrenia. Among 62 patients with a postconsultation diagnosis of treatment-resistant schizophrenia (TRS), 56% (N=35) received this diagnosis only after consultation. Nearly all of these patients were advised to begin taking clozapine, and electroconvulsive therapy was less commonly recommended.

Conclusions:

Expert consultation facilitates timely identification and optimal treatment of schizophrenia and its more severe subtype, TRS.

Get full access to this content

View all available purchase options and get full access to this content.

Get Access

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 10 • October 01, 2024
Pages: 1035 - 1038
PubMed: 38938091

History

Received: 14 December 2023
Revision received: 29 February 2024
Accepted: 15 April 2024
Published online: 28 June 2024
Published in print: October 01, 2024

Keywords

  1. second-opinion consultation
  2. psychotic disorders
  3. schizophrenia spectrum disorder
  4. treatment-resistant schizophrenia
  5. clozapine

Authors

Details

Carol Lim, M.D., M.P.H. [email protected]
Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Harvard Medical School, Boston (Lim, Donovan, Cather, O. Freudenreich); Tufts University, Medford, Massachusetts (S. Freudenreich); North Suffolk Community Services, Boston (Maclaurin).
View all articles by this author
Abigail L. Donovan, M.D.
Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Harvard Medical School, Boston (Lim, Donovan, Cather, O. Freudenreich); Tufts University, Medford, Massachusetts (S. Freudenreich); North Suffolk Community Services, Boston (Maclaurin).
View all articles by this author
Sophie Freudenreich
Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Harvard Medical School, Boston (Lim, Donovan, Cather, O. Freudenreich); Tufts University, Medford, Massachusetts (S. Freudenreich); North Suffolk Community Services, Boston (Maclaurin).
View all articles by this author
Corinne Cather, Ph.D.
Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Harvard Medical School, Boston (Lim, Donovan, Cather, O. Freudenreich); Tufts University, Medford, Massachusetts (S. Freudenreich); North Suffolk Community Services, Boston (Maclaurin).
View all articles by this author
Sarah Maclaurin, P.M.H.N.P.
Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Harvard Medical School, Boston (Lim, Donovan, Cather, O. Freudenreich); Tufts University, Medford, Massachusetts (S. Freudenreich); North Suffolk Community Services, Boston (Maclaurin).
View all articles by this author
Oliver Freudenreich, M.D., F.A.C.L.P.
Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Harvard Medical School, Boston (Lim, Donovan, Cather, O. Freudenreich); Tufts University, Medford, Massachusetts (S. Freudenreich); North Suffolk Community Services, Boston (Maclaurin).
View all articles by this author

Notes

Send correspondence to Dr. Lim ([email protected]).

Competing Interests

Dr. Lim reports receiving research grants from Karuna, Merck, and Neurocrine Biosciences; consultant honoraria from Karuna; and medical honoraria from MDedge and Hatherleigh. Dr. Donovan reports that her spouse owns equity in Mirah and is a board member of Artisan Industries Corporation, in which she owns equity. Dr. Cather reports receiving consulting income from Navigate Consultants. Ms. Maclaurin reports receiving research grants from Alkermes and Janssen and consultant honoraria from Alkermes and the American Psychiatric Association. Dr. O. Freudenreich reports receiving research grants from Alkermes, Janssen, and Otsuka; consultant honoraria from the American Psychiatric Association, Integral, and Janssen; medical honoraria from Elsevier and Medscape; and royalties from UpToDate. Ms. S. Freudenreich reports no financial relationships with commercial interests.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard
Tips for downloading citations

View Options

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Item saved, go to cart
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Media

Figures

Other

Tables

Share

Share

Share article link

Share

×

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.