The concept of FEP is important as the nature of the presentation of psychosis and the associated biopsychosocial correlates has lot of bearings on the overall outcome and course of the illness. It may help understand multiple risk and protective factors for the course and outcome of psychotic illness and may clear the cloud to sharpen the evidence toward commonality and distinctiveness between various psychotic diagnoses in vogue for more comprehensive concept.įirst-episode psychosis (FEP) is an episode of mental illness where symptoms qualify for a psychosis and there has not been a psychotic episode before the index episode. FEP may prove to be an important concept to understand psychosis in general without putting things into the diagnostic rubric. Efforts have been made to calculate polygenic risk score based on genes involvement/sharing between various psychotic spectrum disorders as well as biomarker panels to identify people at risk. Many risk and protective factors have been brought out with varying certainty ranging bio-psycho-social spectrum. The study has attempted to view FEP both as horizontal spectrum across various diagnoses and longitudinally ranging from asymptomatic individual with unknown risk status to attenuated psychosis to multiple relapses/unremitting illness. FEP constituted a clinical psychotic phenomenon with underlying significant heterogeneity in diagnosis, stability, course, and outcome. A literature review of available articles addressing the concept, phenomenology, evolution, identification, course, and outcome of FEP was done the same was subsequently divided into broad topics for better clarity and analyzed. A comprehensive review of the literature will help us understand the evolution and trajectory of this concept better. Study of first-episode psychosis (FEP), an episode of psychotic nature which manifests for the first time in an individual in the longitudinal continuum of his/her illness, has been study matter of research interest in recent years.
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