Early Intervention in Psychosis - Dr. Samantha Torres, MD

CLINICAL REVIEW • AUGUST 2003

Early Intervention in Psychosis:
Why Timing Matters

By Samantha Torres, M.D.
Board-Certified Neuropsychiatrist

>> Why Timing Matters

Research consistently shows that the earlier psychosis is identified and treated, the better the long-term outcomes. The period from the first emergence of psychotic symptoms to the initiation of treatment is called the "duration of untreated psychosis" (DUP), and shorter DUP is associated with:

Better response to treatment
More complete symptom remission
Better cognitive and functional outcomes
Lower risk of relapse
Better quality of life

The Critical Window
The first 2-5 years after psychosis onset appear to be a "critical period" during which the trajectory of the illness is largely determined. Intervention during this window can have lasting effects on outcomes.

>> Warning Signs to Watch For

Psychosis typically emerges in late adolescence to early adulthood. Warning signs that families should watch for include:

Category	Signs
Thinking	Unusual beliefs, suspiciousness, difficulty concentrating, confused thinking
Perception	Hearing or seeing things others don't, heightened sensitivity to sounds/lights
Behavior	Social withdrawal, decline in function, neglecting hygiene, odd behavior
Mood	Depression, anxiety, irritability, flat emotions, inappropriate emotions
Sleep	Significant changes in sleep patterns, day-night reversal

>> The Prodromal Period

Many people experience a "prodromal" period before full psychosis develops—a phase of subtle changes that can last months to years. During this time, early intervention may prevent or delay the onset of frank psychosis.

Prodromal signs may include:

Vague, subtle unusual thoughts (not yet delusions)
Perceptual disturbances (not yet hallucinations)
Difficulty filtering information
Trouble with abstract thinking
Declining grades or work performance
Increasing social isolation
Loss of motivation

Note: Many of these signs overlap with normal adolescent development, depression, anxiety, or substance use. This is why professional evaluation is essential—not every person with these signs will develop psychosis.

>> What Early Treatment Looks Like

Modern early intervention programs take a comprehensive approach:

1. Careful Assessment
Thorough evaluation to confirm diagnosis, rule out other conditions, and assess severity and risk.

2. Low-Dose Medication
When antipsychotic medication is indicated, starting with lower doses than traditionally used can be effective while minimizing side effects.

3. Psychotherapy
Cognitive behavioral therapy adapted for psychosis (CBTp) helps manage symptoms and improve coping.

4. Family Support
Education and support for family members improves outcomes significantly.

5. Supported Education/Employment
Helping young people maintain their developmental trajectory.

>> For Families: What You Can Do

If you're concerned about a loved one:

Trust your instincts — You know your family member best
Seek evaluation early — Don't wait for a crisis
Choose specialists — Look for clinicians with experience in early psychosis
Be patient and supportive — Recovery takes time
Educate yourself — Knowledge reduces fear and stigma
Take care of yourself — Caregiver wellbeing matters

Early Assessment Available

Dr. Torres provides comprehensive evaluation for young people experiencing concerning changes and offers evidence-based early intervention approaches.

--> Request a Consultation <--

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>> Statistics

• ~3% of people experience psychosis

• Peak onset: ages 15-25

• Avg DUP: 1-2 years

• Early treatment improves outcomes 50%+

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