🧩 First-Episode Psychosis Simulator

Prodromal Phase Before Overt Psychosis

Subtle cognitive and social changes often precede clear psychotic symptoms.

• ~1-2 yrs: Prodrome duration (typical reported range)
• ~20-35%: Conversion rate (high-risk cohorts)
• 18-25: Peak onset age (first episode psychosis)
• CAARMS/SIPS: Detection tools (at-risk screening scales)

What happens in the prodrome

Placeholder: brief functional decline and attenuated symptoms appear here.

Duration of Untreated Psychosis

DUP measures weeks from psychosis onset to first treatment contact.

• ~24 wks: Median DUP (varies widely by setting)
• >52 wks: Long DUP threshold (commonly used cutoff)
• Strong: Outcome link (shorter DUP, better outcome)
• Major driver: Care pathway delay (of prolonged DUP)

Why DUP matters

Placeholder: longer untreated psychosis correlates with worse trajectories.

Antipsychotic Treatment Initiation

First adequate antipsychotic dosing marks the treatment-start milestone.

• 2nd-gen APs: First-line agents (risperidone, olanzapine, etc.)
• 2-6 wks: Response window (early symptom change)
• High: Adherence impact (shapes remission likelihood)
• Recommended: Early intervention (coordinated specialty care)

Starting therapy

Placeholder: initiation timing and dosing set the recovery baseline.

Early vs Delayed Treatment Trajectories

Early-treated cases diverge from delayed-treated cases over time.

• Higher: Early-tx remission (vs delayed treatment group)
• Higher: Delayed-tx relapse (vs early treatment group)
• Persists: Symptom severity gap (years after onset)
• Elevated: Hospitalization risk (with longer DUP)

Diverging curves

Placeholder: the two trajectories separate soon after treatment start.

Long-Term Functional Prognosis

DUP and adherence together predict years-long functional status.

• Varies: Good outcome rate (with DUP and adherence)
• 5-10 yrs: Follow-up horizon (typical outcome studies)
• Protective: Adherence effect (reduces relapse risk)
• DUP: Key modifiable factor (reducible via early detection)

Prognosis summary

Placeholder: shorter DUP plus good adherence yields the best long-run outcome.

Placeholder: early detection programs aim to shorten DUP system-wide.