ABSTRACT

When someone with symptoms of psychosis or someone close to them first seeks psychiatric assistance, the symptoms may have been manifest for years. There may have been contact with primary care or social services, who may not have identified that there is a mental health problem, or have been unable to engage with them. Usually, a situation is reached where the person feels himself to be overwhelmingly controlled by a frightening world and is increasingly suspicious of other people’s attempts to help. It is when the diagnosis of psychosis is made for the first time that assistance can become more adapted to the person’s specific needs. (From this description one realises that we do not know how often psychoses resolve without having been diagnosed because some may simply never present for help.) The aim of intervention is to optimise the treatment of psychosis. The doctor’s underlying aim during the initial contact is also to gain a preliminary understanding of the nature of the psychosis – both medically and psychologically.