2022 Montana Conference On Mental Illness

First-Episode Psychosis Basics

Matt Kuntz with ChatGPT

Matt Kuntz

September 6, 2023

DALL·E 2023-09-05 11.04.01 - painting of a sunrise over a Red Mountain
DALL·E 2023-09-05 11.04.01 - painting of a sunrise over a Red Mountain

Written by ChatGPT and Illustrated by DALL-E based upon prompts by Matt Kuntz

Psychosis is a condition that affects a person's ability to perceive and interpret reality. When a person experiences psychosis for the first time, it is known as a first-episode psychosis (FEP). FEP is a serious mental health condition that can have significant consequences if left untreated. In this blog post, we will explore what FEP is, its symptoms, causes, and how it can be treated.

What is First-Episode Psychosis?

FEP is a term used to describe the first occurrence of psychotic symptoms. These symptoms may include delusions, hallucinations, disordered thinking, or abnormal behavior. Psychosis is not a diagnosis in itself but rather a symptom of various underlying mental health conditions, such as schizophrenia, bipolar disorder, or severe depression.

FEP can occur in people of any age but is most commonly seen in young adults aged between 16-30 years old. The onset of symptoms is often sudden and can be distressing for both the individual experiencing them and their loved ones.

Symptoms of First-Episode Psychosis

The symptoms of FEP can vary from person to person, but the most common symptoms include:

  1. Delusions: False beliefs that are not based on reality, such as believing that someone is out to harm them or that they have special powers or abilities.

  2. Hallucinations: Sensory experiences that are not based in reality, such as hearing voices that no one else can hear or seeing things that are not there.

  3. Disordered thinking: Thoughts that are disorganized, making it difficult for the person to communicate or express themselves.

  4. Abnormal behavior: Behavior that is unusual or bizarre, such as acting in a paranoid or aggressive manner.

  5. Withdrawal from social interactions: Avoiding social activities, hobbies, and interests.

Causes of First-Episode Psychosis

The exact causes of FEP are not known, but research suggests that a combination of genetic, environmental, and psychological factors may contribute to its development. Some of the factors that may increase the risk of developing FEP include:

  1. Genetics: A family history of mental health disorders, particularly schizophrenia or bipolar disorder.

  2. Substance abuse: Using drugs or alcohol can increase the risk of developing FEP.

  3. Trauma: Exposure to traumatic events, such as physical or sexual abuse, can increase the risk of developing FEP.

  4. Stress: High levels of stress can trigger the onset of FEP in some individuals.

  5. Brain abnormalities: Structural or functional abnormalities in the brain may contribute to the development of FEP.

Treatment for First-Episode Psychosis

FEP is a serious condition that requires prompt treatment to improve the chances of a full recovery. Treatment may involve a combination of medication, psychotherapy, and support services, such as vocational training or social skills training.

Medication: Antipsychotic medications are the primary treatment for FEP. These medications can help reduce the symptoms of psychosis and improve the person's ability to function.

Psychotherapy: Different types of psychotherapy, such as cognitive-behavioral therapy (CBT) or family therapy, may be helpful in treating FEP. CBT can help the person learn to identify and challenge their delusions and negative thoughts, while family therapy can help improve communication and reduce conflict within the family.

Support services: Vocational training and social skills training can help the person with FEP to develop the skills needed to live independently and engage in social activities.

In some cases, hospitalization may be necessary to stabilize the person's condition and ensure their safety.


First-episode psychosis is a serious mental health condition that can have a significant impact on a person's life if left untreated. It is important to seek help from a mental health professional if you or someone you

Related Research:

Skikic, M., & Arriola, J. A. (2020). First Episode Psychosis Medical Workup: Evidence-Informed Recommendations and Introduction to a Clinically Guided Approach. Child and adolescent psychiatric clinics of North America, 29(1), 15–28. https://doi.org/10.1016/j.chc.2019.08.010 

Bora, E., Yalincetin, B., Akdede, B. B., & Alptekin, K. (2018). Duration of untreated psychosis and neurocognition in first-episode psychosis: A meta-analysis. Schizophrenia research, 193, 3–10. https://doi.org/10.1016/j.schres.2017.06.021

Ouellet-Plamondon, C., Abdel-Baki, A., & Jutras-Aswad, D. (2021). Premier épisode psychotique et trouble de l’usage de substance concomitants : revue narrative des meilleures pratiques et pistes d’approches adaptées pour l’évaluation et le suivi [First Episode Psychosis and Substance Use Disorder: Narrative Review of Best Practices and Adapted Approaches for Assessment and Monitoring]. Sante mentale au Quebec, 46(2), 277–306. 

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