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Secondary causes among adult patients presenting with first-episode psychosis to acute medical settings in Hong Kong: A 10-Year retrospective study
Chau, S. W. H.; Lam, L. K.; Yu, M. P.; Wong, Y. C.; Choi, J. C.; Leung, H. H.. medRxiv (preprint), 2026-09-04
Topic: Risk, prevention and care in population studies
BackgroundThe prevalence and pattern of secondary causes of first-onset psychosis (FEP) in Asian populations are understudied. Our objectives are to investigate the prevalence and pattern of secondary causes of FEP presenting in an acute medical setting in a metropolitan, Chinese-predominant population, and to investigate the prevalence and pattern of undiagnosed conditions presenting as psychosis. MethodThis is a retrospective observational study. We reviewed medical records of patients referred to the consultation psychiatry team at a tertiary acute teaching hospital in Hong Kong from January 2015 to Apr 2025. The inclusion criteria of the study are 1) age 18-64 at the time of the assessment, and 2) FEP confirmed by the consultation liaison team. Patients diagnosed with delirium were excluded. ResultAmong the 384 patients included in the study (mean age = 40.0 {+/-}13.7 years, 69% female), secondary causes of psychosis were found in 9.6% (n=37) of the cohort. Substance use is the most common secondary cause found (n=11, 2.9% of all FEPs) overall. Among those with secondary psychoses, patients underlying conditions were revealed only by the workup in relation to the FEP in 16 of them, of which definitive or probable autoimmune encephalitis (n=5) and early-onset dementia (n=4) were the most common conditions uncovered. ConclusionThe prevalence of secondary psychoses in our FEP cohort is lower than published international figures. Clinicians need to be aware of the suspicious clinical features suggestive of autoimmune encephalitis and early-onset dementia in FEP patients with otherwise unremarkable past history and toxicology test.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Chau, S. W. H., Lam, L. K., Yu, M. P., Wong, Y. C., Choi, J. C., & Leung, H. H. (2026). Secondary causes among adult patients presenting with first-episode psychosis to acute medical settings in Hong Kong: A 10-Year retrospective study. medRxiv (preprint). https://doi.org/10.64898/2026.09.02.26362044
Vancouver
Chau SWH, Lam LK, Yu MP, Wong YC, Choi JC, Leung HH. Secondary causes among adult patients presenting with first-episode psychosis to acute medical settings in Hong Kong: A 10-Year retrospective study. medRxiv (preprint). 2026. doi:10.64898/2026.09.02.26362044.
BibTeX
@article{chau2026-852f95a0,
author = {Chau, S. W. H. and Lam, L. K. and Yu, M. P. and Wong, Y. C. and Choi, J. C. and Leung, H. H.},
title = {{Secondary causes among adult patients presenting with first-episode psychosis to acute medical settings in Hong Kong: A 10-Year retrospective study}},
journal = {medRxiv (preprint)},
year = {2026},
doi = {10.64898/2026.09.02.26362044},
url = {https://doi.org/10.64898/2026.09.02.26362044}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Substance use is the most common secondary cause found (n=11, 2.9% of all FEPs) overall.
- Among those with secondary psychoses, patients underlying conditions were revealed only by the workup in relation to the FEP in 16 of them, of which definitive or probable autoimmune encephalitis (n=5) and early-onset dementia (n=4) were the most common conditions uncovered.
Why it matters
This retrospective study of first-episode psychosis in Hong Kong found that substance use was the most common secondary cause, and that early-onset dementia was among the conditions uncovered by workup in some patients. It concerns causes of psychosis and does not test any treatment, cure or prevention for Alzheimer's disease.
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Study details
- Participants37
- Effect size9.6%; 2.9%
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 29 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on impact for its field and year and senior author's track record, so those were left out: it earned 26 of the 90 points we could judge it on, which is 29 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv (preprint)) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 37 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Howan HW Leung holds only 1 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | Chinese University of Hong Kong: institution h-index 1,100 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 26 / 90 | Scored on 18 of 20 parts. We have no data for the rest, so they are left out: 26 of the 90 points we could judge it on is 29 out of 100. |
| Total | 29 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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