Early Intervention in Psychosis Summary Report 

What is first episode psychosis?

Psychosis is a medical term which can refer to a single episode or the start of ongoing mental health issues which may lead to the diagnosis of:

  • schizophrenia
  • schizoaffective disorder
  • delusional disorder
  • drug induced psychosis
  • psychotic depression
  • puerperal psychosis
  • bipolar disorder with psychotic features

What are the symptoms?
During an episode of psychosis, perceptions, thoughts, behaviours, and mood are significantly altered. People may experience hallucinations (visual or auditory) and delusions (falsely held beliefs). They may have problems with organisation, motivation, self-care and altered emotional experiences. Some people experience an impaired ability to regulate these experiences effectively.

It is often difficult for clinicians to distinguish between symptoms of psychosis and other mental health problems at an early stage.

What is the potential impact?
If undiagnosed, untreated or poorly treated, psychosis can become a long-term condition. A long duration of untreated psychosis is associated with high rates of suicide, more compulsory care, reduced social functioning, greater relapse, high levels of comorbidity, and greater stress on families. Psychosis in early adulthood has the potential to derail social, vocational, and psychological development.

What are the causes?
Psychosis develops due to an interaction between several biological, genetic, psychological, and social factors occurring over a given period.

There is increasing evidence that structural inequalities significantly increase the risk of psychosis, for example enduring racial discrimination or social marginalisation such as homelessness. There is also an association between frequent use of high THC (strong) cannabis and the development of psychotic symptoms.

Who is affected?
First episode psychosis typically occurs in early adulthood, between late teens and mid-thirties.

Since the outset of the COVID-19 pandemic, Esteem in GG&C has recorded a 20-25% increase in caseload. This is consistent with anecdotal reporting of an increase in psychosis presentations from all NHS boards.

What does recovery look like?
Traditionally psychosis was viewed as an inevitably deteriorating condition, but we now know that people can recover and go on to live healthy, productive lives.

There are three main aspects to recovery:

  • Symptomatic recovery – reduction of symptoms, sustained remission, avoidance of relapse and reduction in distress.
  • Social recovery – increase in time spent in meaningful employment or training, consistent goals and increase in sense of wellbeing.
  • Personal recovery – a fulfilling, meaningful life and a positive sense of identity with self-determination.

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