First Episode Psychosis / Early Psychosis – Key Principles from the Australian Clinical Guidelines for Early Psychosis

Posted on:December 16, 2020
Last Updated: November 9, 2021
Time to read: 6 minutes

The diagnosis and management of early psychosis can pose specific challenges for clinicians.

The presentation of early psychosis is fluid and can encompass a range of symptoms which makes diagnostic categorisation difficult.

On the one hand, it is important that young adults are not misdiagnosed with psychosis while simultaneously recognising that a missed diagnosis can lead to substantial morbidity.

In this article, we summarise the key principles in the assessment and management of First episode psychosis based on the Australian clinical guidelines for early psychosis.

Some of the key features of early psychosis include:

  • Psychotic disorders usually emerge during adolescence or early adulthood. 
  • They tend to be characterised initially by impaired social functioning and nonspecific ’neurotic’ symptoms, which are then followed by attenuated or subthreshold forms of psychotic symptoms and which emerge just before the development of frank psychosis.
  • Psychotic symptoms can be part of the spectrum of normal experiences, with a median prevalence of 5% and incidence of 3% in the general population; between 75% and 90% of psychotic experiences are transitory and disappear with time.
  • Schizophrenia is the third leading cause of burden and injury in young men aged 15–24 years, and the fifth in young women of the same age. 
  • ‘Early psychosis’ refers to the early course of psychotic disorder, and these guidelines specifically refer to the prodrome and the period up to five years from first entry into treatment for a psychotic episode (i.e., first-episode psychosis, or FEP).