First episode psychosis

What is psychotic disorder? How is the first episode treated?

The term ‘psychotic disorders’ describes psychiatric pictures combining elements of delirium and/or hallucinations and/or severe mental disorganisation.

The most representative of psychotic disorders is schizophrenia. It is a disease that most often affects young adults (even adolescents), with repercussions on social and work life that can be very marked.

However, psychotic symptoms can be found in other psychiatric disorders. Therefore, they may be seen in mood disorders (depressive episodes, manic episodes).

Intake of toxics may also cause psychotic phenomena.

Finally, there are situations in which psychotic symptoms can be present, but may only be fleeting and temporary, or of very moderate intensity. These situations are at high risk of developing into a psychotic disorder, especially if the symptoms have physical consequences. Due to the potential risk, these situations are known as ‘an at-risk mental state for psychosis’. All of these situations require close monitoring, however, only 30% of them later progress to a psychotic disorder.

When to consult?

  • Inability to function (drop in school performance, social isolation, change of behaviour);
  • Strange and bizarre behaviour, rambling;
  • Strong, or even resolute adhesion to ideas, or convictions whether strange or otherwise;
  • Feeling endangered, threatened, hostility from the surrounding world;
  • Change in visual perception (sensitivity to colours, contrasts, field depth), hearing (sounds, noises, whispering, muffled words, even clearer, threatening voices or voices uttering insults and commenting on actions), olfactory/gustatory (change in tastes and odours), physical sensations (sensation of bodily transformation, burning, stinging, tightness);
  • Difficulties organising thoughts, difficulty being understood by those around you.

You can attend an assessment consultation at the consultation unit in Nightingale Hospitals Paris – Clinique du Château.

During the consultation, the psychiatrist will look for the various symptoms present and will ask you general questions about your health care pathway and your lifestyle, your medical history, whether you take any toxic substances, etc.

After the consultation, further consultations may be required for the assessment, along with further tests or even a stay in the hospital.

The purpose of the assessment is to characterise the difficulties while taking the person’s general background into account.

If the symptoms constitute a manifest disorder, the purpose of the assessment is to propose as early a diagnosis as possible and appropriate treatment.

Who can consult?

The clinic’s psychiatrists welcome adults wishing to come for an outpatient consultation, wherever their place of residence.

Consultations are subject to extra billing, the remainder to be paid depending on how much your private health care fund contributes.

Families can also make an appointment for a consultation to discuss a next of kin while they’re not there.

If treatment is already ongoing, a second opinion can be requested, ideally after consulting the attending psychiatrist.

Which treatments are offered?

There are a wide variety of situations and treatment can be adapted to each.

Treatment aims to control the symptoms, especially where they are very intrusive. Medication may be required in this case.

Treatment also aims to minimize the functional effects of the disorders. Where appropriate, partner institutions may be called upon to provide support (i.e. Relais Jeunes de Sèvres).

Finally, treatment aims to maintain relationships with family and friends. Persons of trust can be appointed following an interview and where appropriate, the family can be referred to a special support centre (Associations UNAFAM, ARGOS 2001, ProFamille programme).