Early first episode psychosis (FEP) is the first time a young person (typically late teens to mid-20s) experiences a significant break from reality, involving symptoms like hallucinations (hearing/seeing things that aren't there) or delusions (strong, false beliefs), often with confused thinking, social withdrawal, and poor self-care, signaling a serious mental health condition requiring urgent, specialized intervention for better long-term outcomes.
Early or first-episode psychosis (FEP) refers to when a person first shows signs of losing contact with reality. Be aware that the term “first episode” does not mean that there will be additional episodes in the future. What it does mean is that we need to act quickly.
These disruptions are often experienced as seeing, hearing, and believing things that aren't real or having strange, persistent thoughts, behaviors and emotions. Early or first episode psychosis is when a person shows signs of beginning to lose contact with reality.
Phase 1: Prodome (psychosis syndrome)
There may be changes in the way some people describe their feelings, thoughts and perceptions, which may become more difficult over time.
A first episode of psychosis may be triggered by mental health disorders, medical conditions, substance use, or even environmental stressors.
Psychosis can come on suddenly or can develop very gradually. The symptoms of psychosis are often categorized as either “positive” or “negative.”
With early diagnosis and appropriate treatment, it is possible to recover from psychosis. Some people who receive early treatment never have another psychotic episode. For other people, recovery means the ability to lead a fulfilling and productive life, even if psychotic symptoms sometimes return.
But in general, 3 main symptoms are associated with a psychotic episode:
Psychosis involves experiencing something that is not really happening and having a difficult time distinguishing what is real. The three stages of psychosis are prodome, acute and recovery. Psychotic disorders can last for a month or less and only occur once, or they can also last for six months or longer.
Antipsychotic medicines are usually recommended as the first treatment for psychosis. They work by blocking the effect of neurotransmitters, such as dopamine, which are chemicals that transmit messages in the brain. However, they're not suitable or effective for everyone, as side effects can affect people differently.
In cases of hyperactive delirium, symptoms are often mistaken for those of a psychosis—typically schizophrenia or mania. In hypoactive cases of delirium, symptoms may lead to a misdiagnosis of severe depression.
Changed behaviour and catatonia. Other common symptoms of early psychosis include mood swings, sleep disturbances, appetite changes or a loss of energy or motivation. The individual may become more withdrawn or no longer interested in socialising or being active.
While everyone's experience is unique, most people say that psychosis is baffling and wildly frightening. And more people experience psychosis than you may think.
Almost always, a psychotic episode is preceded by gradual non-specific changes in the person's thoughts, perceptions, behaviours, and functioning. The first phase is referred to as the prodrome (or prodromal) phase.
Brief psychotic disorder (BPD) according to DSM-5 is the sudden onset of psychotic behavior that lasts less than 1 month followed by complete remission with possible future relapses. It is differentiated from schizophreniform disorder and schizophrenia by the duration of the psychosis.
You should not dismiss, minimize, or argue with the person about their delusions or hallucinations. Similarly, do not act alarmed, horrified, or embarrassed by such delusions or hallucinations. You should not laugh at the person's symptoms of psychosis.
There is yet inadequate proof to say conclusively that psychosis causes permanent brain damage. But researchers are still pursuing a better understanding of the neurological impact of psychotic episodes.
PCA revealed five distinct components: Delusions of Influence, Grandiose/Religious Delusions, Paranoid Delusions, Negative Affect Delusions (jealousy, and sin or guilt), and Somatic Delusions.
Brief psychotic disorder is triggered by extreme stress, such as a traumatic accident or loss of a loved one. It is followed by a return to the previous level of function. The person may or may not be aware of the strange behavior. This condition most often affects people in their 20s, 30s, and 40s.
Positive symptoms can include experiences such as hearing sounds or voices that others cannot hear, seeing things that others cannot see, odd or upsetting thoughts, suspiciousness of others, beliefs about having special powers and confusion about what is a dream and what is reality.
Oral antipsychotic medicines – namely aripiprazole, chlorpromazine, haloperidol, olanzapine, paliperidone, quetiapine, risperidone – should be offered for adults with a psychotic disorder (including schizophrenia), carefully balancing effectiveness, side-effects and individual preference.
Some warning signs that one may be experiencing mild psychosis include but aren't limited to: Low mood, feelings of hopelessness, and negativity. Paranoia, mistrust, or suspicion without cause. Disorganized thinking and speech patterns.
Life is different for a while after psychosis. You won't feel like yourself and there might be rifts in your life. It might feel empty or depressing. It doesn't end, though.
"We know that there are very high rates of suicide in people with psychosis, compared with the general population," says Tso. "Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time."
medicine – a combination of antipsychotics and antidepressants can help relieve the symptoms of psychosis. talking therapies – the 1-to-1 talking therapy cognitive behavioural therapy (CBT) has proved effective in helping some people with severe depression, including those with psychosis.