Abstracts

Rationale: Psychosis is a common presentation seen in the emergency department and inpatient psychiatry units. New onset psychosis is often secondary to a psychiatric disorder but encephalitis, both auto-immune and infectious as well as unrecognized seizures are in the differential. Autoimmune encephalitides are a group of disorders that have a prominent early psychiatric component. Early identification and treatment of these disorders can lead to better prognosis and earlier recovery. These disorders can also have abnormal EEGs, however, these findings are not specific. The purpose of this study is threefold: 1) assess the trend in EEG ordering in patients with new onset psychosis seen in psychiatry emergency department and inpatient units, 2) determine any common EEG patterns in new onset psychosis patients and 3) determine if initial EEG led to additional workup and treatment.Methods: The ICAHN school of medicine’s internal review board approved the retrospective study to review medical records of patients meeting a diagnosis of psychosis admitted to inpatient psychiatry or seen in the psychiatric Emergency Room at Mount Sinai Hospital from January 2005 to June 2014. Charts will be divided into new onset or recurrent psychosis. EEG order frequency, EEG result patterns, and additional workup (imaging, spinal fluid, consults) stemming from EEG results will be analyzed. 7000 charts have been identified meeting the criteria with emergency room or inpatient psychiatry admissions during this timeframe.Results: 7000 charts have been identified meeting the criteria for psychiatric admission or psychiatric emergency room visit for psychosis. These will be separated into new onset and recurrent psychosis. EEG ordering frequency, results, and change of management will be investigated as described above.Conclusions: EEG evaluation of psychotic patients can be a helpful tool in identifying non-psychiatric conditions that may be causing psychosis such as autoimmune encephalitis or seizures. This study can serve as evidence that EEG should be part of the initial evaluation of the newly psychotic patient. Additionally, we expect with better understanding and recognition of autoimmune encephalitis as part of the differential that the number of EEGs ordered on psychotic inpatients will have increased over time.