Harvard Mental Health Letter

Treating "first-episode" schizophrenia

Current thinking about the best way to manage this critical phase.

Schizophrenia is usually diagnosed for the first time following an episode of full-blown psychosis. Consensus is growing that this first psychotic episode represents a critical period for treating schizophrenia. It offers a unique opportunity to build a therapeutic alliance between patient and clinician, get treatment "right" the first time around, and do everything possible to improve long-term outcomes.

The evidence so far suggests that multimodal treatment for patients with first-episode schizophrenia — ideally through integrated programs that combine medication, individual and group therapy, and assertive community treatment — is more likely to provide relief from symptoms and to improve the chances of preserving healthy functioning in the long run.

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