Psychosis involves a disruption of thought processes marked by hallucinations and delusions. In
the early stages of a psychotic illness a definitive diagnosis can be extremely difficult to make.

These guidelines are intended principally for use by health care professionals in primary care
settings. They are designed to improve assessment, treatment and access to specialist services
for Salford patients.

Psychosis Epidemiology
• 3% of the population will be diagnosed with some form of psychotic disorder.
• Psychosis affects men and women equally.
• Psychosis is more prevalent in urban areas than rural areas, by a factor of 2 for males
and 5 for females.
• The average treatment lag from onset of symptoms to onset of treatment is one year.
• The longer the treatment lag, the worse the prognosis.
• The high-risk age range is from 14 - 35.

How Were Service Users Consulted/Involved?
• Engagement of Salford Mental Health Forum (user group) in the endorsement of the guidelines.
(See introduction section).

What Aspects Will Be Monitored & Measured To Access Impact In Primary Care?
• Duration of untreated psychosis in Salford.
• Monitoring adherence to appropriate referral Pathways to specialist care. (Referral Audits)

What Evidence And/Or National Guidance Was Used In Developing The Guidelines?
- Yung et,al (1998) A step towards indicated prevention of schizophrenia. British Journal of
Psychiatry, 172 (suppl.33) 14 - 20.
- French et al (2001) “Cognitive therapy for preventing transition to psychosis in high risk indivuals:
a single case study”. In Morrison A.P (Ed) A case book of cognitive therapy for psychosis.
- Morrison, A .P, Bentall, R. P., French, P., Walford, L., Kilcommons, A., Knight, A.,
Kreutz, M., & Lewis, S.W. (2002). A randomised controlled trial of early detection and cognitive
therapy for preventing transition to psychosis in high risk individuals: study design and interim
analysis of transition rate and psychological risk factors. Bristish Journal of Psychiatry 181,
(supplement 43) 78-84.
- DoH (2000) The NHS Plan, A Plan for Investment, A Plan for Reform. HMSO London.
- DoH (1999) Modern Standards and Service Models: A National Service Framework for Mental
Health. HMSO Lodon.
- McGorry, P. & Jackson, H. (1999) Recognition and management of first episode psychosis:
a preventative approach. Cambridge University Press.
- Lester, H. (2001) 10 minute consultation first episode psychosis. British Medical Journal, 323,
1408.

Who Designed These Guidelines?
Paul French, Research Cognitive Therapist, BSTMHT (lead clinical expert 1).
Dr. Tony Morrison, Snr Lecturer in Clinical Psychology, Manchester University (lead clinical expert
2). All core members of Mental Health Guidelines Development Group (see document introduction
for members list).

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