Background: A delay in the recognition of first episode psychosis is common and is often associated with psychological distress, social decline, and as recent evidence suggests, lasting brain changes. It is increasingly evident that early intervention potentially alters the course of these serious mental illnesses. General practitioners are ideally placed to identify early changes that may herald an emergent psychotic illness and to bridge the existing gap between patients, their families and specialist mental health services.
Objective: This article summarises the rationale and importance of early detection of emerging psychotic illness in young people, and provides practical tips regarding its assessment and detection.
Discussion: Early warning signs of emerging psychotic illnesses include behavioural, emotional and cognitive disturbances. Risk factors include a combination of a family history of a psychotic illness coupled with a decline in functioning, or a history of a brief self limiting psychotic episode (even if triggered by drugs such as cannabis or amphetamines). It is important that those working in primary care recognise these features in order to facilitate a speedy referral to specialist youth friendly mental health services, or if such services are not available, to initiate treatment and provide appropriate ongoing management.