What is Psychosis?

Psychosis is a symptom describing the distortion or loss of contact with reality, often accompanied by hallucinations, delusions and disorganized thoughts and/or behavior. There are many causes of psychosis including substance intoxication or withdrawal, an adverse effect of prescribed medications, metabolic abnormalities, infection and sleep deprivation, to name a few. Many are short-lived and resolve when the underlying disorder is treated.

What are Psychotic Disorders?

Psychotic disorders are brain-based mental illnesses characterized by repeated episodes of psychosis or ongoing psychotic symptoms. The most severe and disabling psychotic illness is Schizophrenia. Another is Schizoaffective Disorder, similar to Schizophrenia, with mood symptoms as well. Bipolar Disorder or Major Depression can be accompanied by psychotic symptoms in some, during a severe manic or depressive episode, along with a few other disorders that are less often accompanied by psychosis.

People with psychotic disorders usually experience psychosis in episodes, often with low levels symptoms between episodes. The overall course of psychotic illnesses can be described as follows:

  • Premorbid (at risk) – The person does not experience any symptoms but has risk factors (genetic, traumatic, pre- or peri-natal complications, substance abuse) for developing psychosis.
  • Clinical High Risk (CHR/Prodromal)— (becoming unwell) - The person has some changes in their emotions, motivation, thinking and perception and/or behavior (See Early Warning Signs). This period may last 1-5 years, and on average about 2 years. This is the phase in which early intervention is most effective in preventing progression. (See early warning signs)
  • Acute (Psychotic phase) – The person is unwell with psychotic symptoms such as delusions, hallucinations, disorganized thinking and reduction in ability to maintain social relationships, work or study. People often require hospitalization during this phase.
  • Recovery – Follows an acute episode and may take months to approach pre-psychotic level of functioning and well-being. Many people experience some loss of functioning compared to their pre-morbid level of functioning.
  • Relapse – Recurrence of an acute episode after a period of stability. While some people have only one psychotic episode in their lifetime, the majority go on to have other acute episodes periodically. Each episode takes longer to resolve and is more difficult to treat, and often results in a decrease in functioning.

What is the Impact of Psychotic Disorders?

Psychotic disorders are of major social and public health importance. The personal and societal cost of these disorders is considerable. Psychosis can severely disrupt a person’s life, making relationships, school, work, and self-care difficult to initiate or maintain. These conditions affect a significant number of individuals in our community. If we consider all psychotic disorders together, around 3% of people will experience a psychotic episode at some stage in their life and 1% will be diagnosed with Schizophrenia. Usually a first episode occurs in adolescence or early adult life, an important time for the development of identity, relationships and long-term vocational plans. And, when the impact on the individual’s family is also considered, the indirect effects of these conditions are enormous.

Early intervention programs, like First Hope, target the Clinical High Risk phase during which the greatest long-term impact is possible. There is evidence that intensive services just after the first acute episode improve the overall prognosis as well.

What does it mean to be at Clinical High Risk for Psychosis?

Determination that an individual is at “Clinical High Risk” for developing psychosis can only be made by trained mental health professionals. The First Hope program uses a structured clinical interview to identify the signs and symptoms for being at-risk for developing a psychotic disorder. Our assessment process identifies low-level versions of the symptoms of psychotic illness. Recent studies show that up to 35% of young people with the Clinical High Risk syndrome develop a psychotic disorder such as Schizophrenia over the next 2 years.

It is important to note that even if someone is determined to be “at-risk”, the majority will not develop psychotic illness. That’s why we treat only the symptoms the person has right now. These symptoms themselves are usually troubling to the young person and loved ones.

If you have any questions or concerns please call contact us!

Phone: 925-681-4450
Fax: 925-646-5365
1034 Oak Grove Rd.
Concord, CA. 94518

Facts and Myths

Myth: Mental illness is the result of bad parenting.

Fact: Most experts agree that a genetic susceptibility, combined with other risk factors, leads to a psychiatric disorder. In other words, mental illnesses have a physical cause.

Myth: Psychiatric disorders are not true medical illnesses like heart disease and diabetes. People who have a mental illness are just "crazy."

Fact: Brain disorders, like heart disease and diabetes, are legitimate medical illnesses. Research shows there are genetic and biological causes for psychiatric disorders, and they can be treated effectively.


Myth: People with a severe mental illness, such as schizophrenia, are usually dangerous and violent.

Fact: Statistics show that the incidence of violence in people who have a brain disorder is not much higher than it is in the general population. Those suffering from a psychosis such as schizophrenia are more often frightened, confused and despairing than violent.