Intended for healthcare professionals


Early intervention for first episode psychosis

BMJ 2004; 328 doi: (Published 17 June 2004) Cite this as: BMJ 2004;328:1451
  1. David Shiers (, joint director of the National Development Network for Early Intervention,
  2. Helen Lester (, national primary care career scientist
  1. National Institute of Mental Health for England, West Midlands, West Midlands Mental Health Development Centre, Redditch B97 4DE
  2. Department of Primary Care and General Practice, Medical School, University of Birmingham, Birmingham B15 2TT

    Needs greater involvement of primary care professionals for its success

    Early intervention in psychosis is a relatively new concept in mental health. It describes the policy of the health service and its response to increasing evidence of unacceptably long delays in accessing specialist services and the benefits of earlier detection and treatment for young people who experience their first episode of psychosis (when someone displays typical symptoms, such as distorted contacts with reality, delusions, hallucinations, and thought disorder, and no organic disorder can be found to explain those symptoms). It is also a concept that requires primary and secondary care and wider involvement of the community to make a difference to the outcome.

    Like most mental disorders, functional psychoses such as schizophrenia and bipolar affective disorder usually appear when people are young (80% of first episodes of psychoses occur between 16 and 30 years of age), at a critical time in their intellectual and social development and emerging personal autonomy. Worldwide, the burden of psychosis is exceeded only by quadriplegia and dementia.1 The all cause standardised mortality ratio for schizophrenia is 298, with an unnatural cause standardised mortality ratio (that includes suicide) …

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