Background:
The typical age of onset for psychotic disorders is concurrent with the typical age of enrollment
in higher education. College and graduate students often experience new academic and social demands that may leave
them vulnerable to substance use and mental health problems, including the initial onset of a psychotic episode.
Objective:
To provide a current overview of the guidelines and literature for the diagnosis and treatment of first-onset
psychosis with special consideration for the college and graduate student population in the United States. To highlight areas of need and provide recommendations for clinicians who work at educational institutions and their health services,
along with general psychiatrists and psychologists who work with post-secondary education populations, to help close the
treatment gap.
Method:
A review of interventions and best practice for the treatment of early psychosis in college students was conducted, informed by the authors’ current experience as clinicians with this population at a United States university.
Results:
Thorough psychiatric interviews and screening tools can help in the early identification of individuals at clinical
high risk for and at first onset of psychosis. Coordinated specialty care services are the gold standard for early psychosis
services, including psychotherapy (such as cognitive behavioral therapy and individual resiliency training), as well as support for a student to return to school or work. Individuals experiencing a first episode of psychosis in general respond better to lower doses of antipsychotics and may also experience more adverse effects.
Conclusion:
Return to a high level of functioning is possible in many cases of first onset of psychosis, and early identification and treatment is essential.
