1st Step Early Psychosis Intervention Program

Disorganized or confused thinking, speaking and behavior. Thoughts become confused and seem to either speed up or slow down. Disorganized behavior examples:

1. Difficulties performing activities of daily living (e.g., cooking, maintaining hygiene).
2. Marked unkemptness or unusual or inappropriate dress.
3. Inappropriate sexual behavior.
4. Unpredictable and unprovoked agitation.
5. Inappropriate affect (e.g., laughing while describing a personal tragedy).
6. Catatonic behavior.

The individual experiencing psychosis may have difficulties concentrating, following instructions or conversations, and remembering things

• Changes in mood – an empty feeling marked by a lack of emotions, difficulty expressing feelings. Individuals with psychosis may feel strange and cut-off from the rest of the world.
• Delusions – strongly held beliefs which are unusual and unjustified. They are generally organized around one or more of the following themes:

1. Persecutory. Most common. Belief that one is being followed, tormented, or subjected to ridicule.
2. Referential. Also common. Belief that certain gestures, comments, songs, or other environmental cues are specifically directed toward oneself. Grandiose. Belief that one has special abilities or "powers."
3. Religious. Delusions have religious themes (e.g., receiving orders from God)
4. Somatic. Belief that something unusual is occurring in or on one's body, despite medical evidence to the contrary.
5. Loss of Control over Mind or Body. Belief that one's thoughts or body are being controlled by forces or by other individuals. Belief that thoughts are broadcast so others can hear them. A belief that thoughts are being taken out of one's head or are somehow inserted into one's brain.
6. Delusions are considered "bizarre" if they are clearly implausible and are not derived from ordinary life experiences. For example, believing that one's internal organs have been replaced by someone else's without surgery would be considered a bizarre delusion while the belief that one is being followed by the police would be considered non-bizarre.

Hallucinations – seeing, hearing, feeling, smelling or tasting things that do not actually exist.
1. Auditory hallucinations are the most common. They are usually experienced as voices that are perceived as distinct from the individual's own thoughts.
2. Visual hallucinations are often of a disturbing and intrusive type.