The neurological examination is a key part of the diagnostic evaluation of psychiatric patients. There is general agreement that the canonical neurological examination should be modified for psychiatric patients, however there is a lack of consensus around what this should entail. We reviewed the literature on proposed neurological examinations for a psychiatric clinical setting. A systematic review, following PRISMA guidelines, was conducted to identify all published neurological examinations aimed at adult psychiatric patients. Information on items, length and target population was extracted for each examination. A total of 20 proposed neurological examinations were identified (9 general adult; 4 older adult; 7 general and older adult). All examinations covered the broad components of a canonical neurological examination, including assessments of the upper limbs, lower limbs, and cranial nerves. In addition to this, inspection for involuntary movements and assessment of primitive reflexes were commonly included. Neurological examinations for older adults were typically lengthier, and frequently recommended testing for olfaction and functional ability. However, the strength of the evidence supporting all proposed examinations was low, relying heavily on expert opinion. Existing neurological examinations in psychiatry exhibit several weaknesses, which limit their use in routine psychiatric care. There is a need for a brief, evidence-based neurological examination that is feasible to implement in a psychiatric setting.

There's a general lack of knowledge about autism attributes in early psychosis, although little initial evidence showed that having autistic features contributes to poorer recovery over time. The main aim of this examination was to compare sociodemographic and clinical variables between FEP patients with or without autistic characteristics treated within an "Early Intervention in Psychosis" (EIP) service both at entry and across 2years of follow-up. We also examined the longitudinal course of autism severity levels in FEP to investigate whether they truly represented trait-like attributes. FEP participants completed the AQ-spectrum Questionnaire (AQ), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) at baseline and over time. Inter-group comparisons were examined using Chi-Squared or Mann-Whitney test, Kaplan-Meyer survival analysis, mixed-design ANOVA, and binary logistic regression. AQ score longitudinal stability was explored using Wilcoxon test for repeated measures and Spearman correlation coefficient. 132 subjects were recruited (28 [21.20%] scored above the AQ cut-off score of≥26). At presentation, they showed younger age and higher severity in psychopathology (especially negative symptoms). Across the follow-up, the AQ+ subsample had lower incidence rates of service disengagement, PANSS symptomatic remission, and GAF functional remission. AQ scores showed longitudinal stability over time. The AQ represents a valid instrument to assess "trait-like" autistic features in FEP subjects. Specifically, it captures a distinct FEP subgroup characterized by more severe clinical presentation, poorer clinical and functional outcomes, and specific therapeutic needs.