Phases of first episode psychosis

Breakthrough

First episode psychosis has four phases: prodromal, acute, early recovery and late recovery.

Prodromal phase
This period prior to the development of psychotic symptoms features early warning signs, especially negative symptoms, which reflect an excess or distortion of normal functions. These prodromal indicators, for example, mood swings and appetite changes, may be difficult to distinguish from transient states associated with developmental or life stages and circumstances.

Acute phase
This phase is characterized by positive symptoms, which reflect a diminution or loss of normal functions, including hallucinations, delusions and thought disorder. It is usually during this phase that the person presents for treatment. Treatment goals include resolving the psychosis, preventing or treating accompanying conditions such as substance abuse and promoting adjustment and psychosocial recovery.

Early recovery phase
This phase constitutes the first six months following acute treatment. The focus is on developing a psychosocial framework for further recovery as positive symptoms recede. Interventions include individual and family counselling and other cognitive and skills-based therapies.

Late recovery phase
This phase follows the early recovery phase for six to 18 months. Decisions must be made about length of maintenance medication and other treatment supports. The goal is to continue to promote full recovery and prevent relapse. Relapse rates of 50 per cent within 10 months following the end of medication have been reported for first episode cases.

Source: Canadian Mental Health Association

 

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