PROLONGED RECOVERY IN FIRST-EPISODE PSYCHOSIS

Background Early identification and specialised treatment of individua ls with enduring positive symptoms may assist in alleviating symptoms and has the potential to change the course of illness. Method Prevalen ce and descriptive data on enduring positive symptoms in two first-epi sode samples are outlined. Attempts to incorporate the focus of early intervention for persisting psychosis into routine clinical care of in dividuals with first-episode psychosis are described. Results Of the 2 27 individuals with first-episode psychosis who were assessed using th e Brief Psychiatric Rating Scale at 3/6 months and 12 months following initial stabilisation (from a total sample of 347), 6.6% experienced enduring positive symptoms at all three time points.When the analysis was restricted to schizophrenia, schizophreniform and schizoaffective disorders (n=158) the percentage increased to 8.9%.These patients had significantly longer mean duration of untreated psychosis prior to ini tiation of treatment and, at 12-month follow-up, significantly higher depression and poorer psychosocial functioning Conclusions The associa tion of untreated psychosis with treatment resistance supports the arg ument for early intervention as soon as possible following the onset o f psychotic symptoms.