Early Onset Psychosis
Psychosis can be a frightening term. It includes some of the most challenging symptoms that people with a variety of psychiatric diagnoses may experience. Most commonly associated with schizophrenia, symptoms of psychosis can also occur in severe mood disorders, severe depression, bipolar disorders, and at times in severe stress reactions.
Because these symptoms, which can include hallucinations, delusions, or extremely disorganized thought patterns, can be very disturbing to the people experiencing them and those around them, it’s critically important to obtain an accurate diagnosis – and patients and their families should know that with early diagnosis and treatment, a person with psychosis can learn to manage their symptoms and live a full, productive life.
Treatment for Early Onset Psychosis: Accurate, Timely Diagnosis and Evidence-Based Intervention
The diagnostic assessment must ensure that medical, neurological, and substance use-related causes are excluded. Whatever the diagnosis, evidence shows early intervention and consistent treatment significantly improve prognosis for patients diagnosed with a mental health disorder that include symptoms of psychosis.
What is Psychosis?
The National Alliance on Mental Illness (NAMI) offers this definition of psychosis:
“…disruptions to thoughts and perceptions that make it difficult for an individual recognize what’s real and what isn’t. These disruptions are often experienced as seeing, hearing, and believing things that aren’t real or having strange, persistent thoughts, behaviors, and emotions.”
Fundamentally, psychosis represents a disturbance in a person’s grasp of reality, whether that is in their perceptions (hallucinations), beliefs (delusions, including paranoia), or their ability to think or express themselves coherently (thought disorder).
Mental health disorders that may include early onset psychosis and/or symptoms include:
Schizophrenic disorders
- Schizophrenia
- Schizoaffective disorder
- Schizophreniform disorder
These disorders, including related symptoms of psychosis, most often emerge between ages 17-25, but the first episodes can occur well into adulthood, as late as age 40.
Brief psychotic disorder
Also known as acute and transient psychotic disorder, associated symptoms of psychosis commonly appear by age 18, but may appear as late as age 35.
Mood disorders
- Major depressive disorder (MDD)
- Bipolar disorder I & II
The average age of onset of symptoms of psychosis in mood and related disorders is around 18-20 years old, but may appear during later adulthood, as well. It’s extremely rare for symptoms of psychosis to appear in children or early adolescents.
Symptoms of Psychosis and Age: Important Facts for Families
In rare cases, patients may develop the symptoms of psychosis we describe below in childhood or early adolescence. When symptoms appear early, there’s typically a clear family history of psychosis, but not always. At BACA, we have the knowledge and experience to treat these early cases in the context of whichever mental health or behavioral disorder they appear.
Early Onset Psychosis: What are Hallucinations and Delusions?
The National Alliance on Mental Illness
“Things a person sees, hears, or feels – i.e. sensory perceptions – when there is no real or identifiable source that causes those perceptions.”
Early Onset Psychosis: Hallucinations
Hallucinations most often associated with psychosis and early onset psychosis include:
Auditory
Auditory hallucinations occur when a person hears sounds that aren’t there. They’re the most common type of hallucination, and most often involve hearing voices.
Visual
Visual hallucinations occur when a person sees things that aren’t there. Visual hallucinations aren’t always sinister or disturbing, but more often simply unusual or confusing.
Olfactory
Olfactory hallucinations occur when a person smells things that aren’t there. They may be pleasant or unpleasant. Olfactory hallucinations may occur in short episodes, or they may be present constantly.
Touch
Touch, or tactile hallucinations, occur when a person experiences physical sensations that have no real external cause, such as tingling on the skin, or the sensation of being tapped on the arm or shoulder when no one is there.
Early Onset Psychosis: Delusions
The National Alliance on Mental Illness (NAMI) defines delusions as:
“Thoughts or beliefs held by a person that are objectively and demonstrably false or untrue.”
Delusions most often associated with psychosis/early onset psychosis include:
Grandeur/Over-Inflated Sense of Self
A person with these types of delusions often believes – with absolute certainty – they possess powers, knowledge, secret talents, or special skills no one else has.
Persecution
A person with this type of delusion becomes certain that some type of external force exerts power over them and actively seeks to cause them harm when there’s no tangible evidence to support the belief
Thoughts/Thought-Related
For some people, delusions take the form of errant beliefs about the thoughts inside their head. They may arrive at the conclusion – with no concrete external evidence – that their thoughts are/have been:
- Under the direct control of external factors, including other people, entities, or forces
- Planted in their brains by external entities, forces, or other people
- Stolen directly out of their minds by external entities, forces, or other people
- Read, made audible, or made accessible/known to others, by some external force, entity, or person
Relationship/Relationship-related
These types of delusions involve real and/or fictitious relationships. In real relationships, a person may develop the delusion – with no real evidence – that their partner is unfaithful/cheating on them. In addition, a person with relationship-related delusions may believe they’re in a serious romantic relationship or a deep friendship with someone they’ve never met and don’t know, such as a celebrity or famous person.
Treatment for Early Onset Psychosis and Psychosis at BACA:
Outpatient psychiatric evaluations and psychiatric care for patients with early onset psychosis.
Evaluations
- Psychiatric evaluations for psychosis/early onset psychosis administered by certified child & adolescent psychiatrist.
Psychotherapy
- Ongoing outpatient psychiatric management and care for new patients evaluated by BACA psychiatrist.
- Ongoing outpatient psychiatric management and care for patients fully evaluated at a different specialty center.
10 Board Certified Child & Adolescent Psychiatrists
We do not require patients have such a specialty evaluation prior to intake at BACA, but we are a solution for ongoing psychiatric management afterwards.
General Adolescent PHP/IOP
Patients in treatment for early onset psychosis at BACA must be stabilized to a level appropriate for participation in group therapy in an IOP or PHP setting. We do not accept patients who are acutely agitated, unsafe for themselves or others, or are unable to participate in group therapy due to paranoia, thought disorder, or hallucinations.
For appropriately stabilized patients aged 11-18 with diagnoses of early onset psychotic disorders, BACA clinicians provide:
- Individual cognitive behavioral therapy (CBT)
- Active medication management
- Family therapy:
- Psychoeducational
- Stress reduction family therapy
- Support for community and academic reintegration
Young Adult/Transitional Age PHP/IOP
Coming Spring 2026
For appropriately stabilized young adult/transitional age patients with diagnoses of early onset psychotic disorders, BACA clinicians will provide:
- Individual cognitive behavioral therapy (CBT)
- Active medication management
- Family therapy:
- Psychoeducational
- Stress reduction family therapy
- Support for community and academic reintegration
