In this episode of The Good GP, host Dr Karin Sekhon is joined by Dr Gordon Shymko, a psychiatrist and clinical director of the Perth Headspace Youth Early Psychosis Program. Dr Shymko brings over 30 years of clinical experience in psychiatry, with a special interest in the management of psychotic disorders and early intervention in youth.

They focused on the topic of first episode psychosis (FEP) and what general practitioners (GPs) need to know to identify and support patients presenting with these conditions. Dr Shymko highlights the crucial role of GPs in early detection, as they are often the first point of contact for young people experiencing subtle changes or distress suggestive of psychosis.

Key topics covered in this episode include:

• Clinical features and presentation of first episode psychosis, include recognising changes in functioning, paranoia, delusional themes, and auditory hallucinations.
• They discussed the typical age of onset and differences between genders.
• The concept of prodromal symptoms and the importance of knowing the patient's baseline functioning.
• The relative rarity of psychotic disorders compared to more common mental health presentations, and the significance of conducting a thorough history to uncover less obvious psychotic or manic symptoms.
• The role of family history in identifying risk of psychosis.
• Recommended organic screening and investigations, and indications for brain imaging or neurological examination.
• Guidance on referral pathways for patients with suspected psychosis, including when to refer to public mental health services, Headspace Early Psychosis Programs, and private psychiatrists, depending on acuity and available resources.

They also discussed the challenges GPs face in accessing specialist mental health services for their patients, and the importance of early intervention in improving long-term outcomes for young people experiencing psychosis.

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