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First Episode Affective Psychosis: Diagnostic and Treatment Considerations

Activity Type:

  • On Demand

Release Date: 2/1/2020

Expiration Date: 2/1/2023

  • AMA PRA Category 1: 1
  • Participation: 1



A substantial number of individuals experience a first episode of psychosis concurrently with a manic or depressive episode, but this group has received less attention than that with non-affective psychosis. There is heterogeneity in symptom presentations and evolution in clinical features over time which present diagnostic and management challenges for the clinician. Although well-accepted treatment algorithms are available for treating mania and depression, less is known about how these treatments perform in the context of a first episode affective psychosis. In this lecture, we will review the current state of the field in first episode affective psychosis, starting with the diagnostic issues and extending into considerations for treatment selection and ongoing management. The focus will be on providing useful information to clinicians working with people with first episode affective psychosis.

* This presentation was recorded at The Second National Conference on Advancing Early Psychosis Care, October 2, 2019


FREE - $0

Funding for this initiative was made possible (in part) by Grant No. 1H79SM080818-01 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. 

Learning Objectives

  • Describe the features of affective vs. nonaffective psychotic disorders in early course of illness.
  • Describe the clinical challenges in working with patients with first episode affective psychosis.
  • Describe the principles of treatment in first episode affective psychosis.

Target Audience

Psychiatrists, psychologists, social workers, counselors, nurses, peer support specialists

Estimated Duration

Estimated Duration: 1.0 hour 
Program Start Date: February 1, 2020
Program End Date: February 1, 2023

Instructional Level


How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit™ or a certificate of participation may do so by completing all sections of the course, including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.

Continuing Education Credit


The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The APA designates this live event for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


  • Jauhar, S., Ratheesh, A., Davey, C., Yatham, L.N., McGorry, P.D., McGuire, P., Berk, M., Young, A.H. (2019). The case for improved care and provision of treatment for people with first-episode mania. Lancet Psychiatry. pii: S2215-0366(19)30082-3. doi: 10.1016/S2215-0366(19)30082-3. [Epub ahead of print]
  • Shalev A, Merranko J, Gill MK, Goldstein T, Liao F, Goldstein BI, Hower H, Ryan N, Strober M, Iyengar S, Keller M. Longitudinal Course and Risk Factors Associated with Psychosis in Bipolar Youth. Bipolar disorders. 2019 Nov 20. 
  • Shinn, A.K., Bolton, K.W., Karmacharya, R., Lewandowski, K.E., Yuksel, C., Baker, J.T., Chouinard, V.A., Pingali, S.M., Bye, H., Cederbaum, K., Öngür, D. (2017). McLean OnTrack: a transdiagnostic program for early intervention in first-episode psychosis. Early Interv Psychiatry.; 83-90. doi: 10.1111/eip.12299. Epub 2015 Nov 29.

Faculty and Planner Disclosures


  • Dost Öngür, MD, PhD, McLean Hospital. Reports no financial relationships with commercial interests.


  • Tristan Gorrindo, MD, American Psychiatric Association.  Reports no financial relationships with commercial interests.

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Hardware/Software Requirements

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Optimal System Configuration

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  • Operating System: Windows XP+ or Mac OS X 10.4+
  • Flash Player: Adobe Flash Player 10.3+ 
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Minimum Requirements

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