Emerging psychosis in young people - Part 2 - key issues for acute management

Abstract

Background: To optimise the management of emerging psychotic disorders in young people, close collaboration between the general practitioner and youth friendly specialist mental health services is favourable. Ideally, a multidisciplinary team including individual case management with expertise in early intervention should treat these patients for the initial 2-5 years. However, only a few areas across Australia currently provide this type of specialised service. Most GPs will at some point be faced with the reality of personally managing young patients with emerging psychotic disorders on their own, sometimes with very limited support.

Objective: This article summarises key issues for the optimal management of emerging psychotic disorders, with a particular focus on the role of the GP.

Discussion: Once an emerging psychotic disorder is confirmed, the engagement of the young person into therapy is the primary target. Ideally therapy integrates not only the patient, but also their family, carers and friends. General practitioners need to inform patients about the nature of the emerging psychotic illness, manage related comorbidities such as substance abuse, and initiate antipsychotic medication to avoid any unnecessary delay in resolution of symptoms. It is important to monitor the patient on a regular basis even after symptom recovery as up to 80% of cases that cease medication will relapse within 5 years.