Comment:

Review differential diagnosis for this first treatment/first onset of psychosis situation: suspect medical causes if:

• patient over age 35
• acute onset
• no family history of psychosis
• past history of substance abuse/dependence
• psychosis developing on a medical ward or in a medical intensive care unit

Get MRI or CT scan if focal neurological signs are present.

Note that 12-24 month delay in recognition of the diagnosis is typical with schizophrenia.¹

Some studies indicate that earlier treatment possibly improves long term outcome, but more recent studies have not confirmed this.²