ABSTRACT
When, as staffon the wards, we meet someone who has developed a psychosis for the first time, one should be cautious about making an absolute diagnosis (McGorry 1994). The overall picture of symptoms change, the affective aspects diminish or become more marked, and delusions can suddenly resolve as the patient finds his way out of his psychotic world. Alternatively the psychosis can worsen with increasing difficulties in making contact. At one time catatonic symptoms may be prominent while at another paranoid symptoms may dominate.
