In this episode of The Good GP, host Dr Karin Sekhon is joined once again by Dr Gordon Shymko, a psychiatrist based in Perth, to discuss what general practitioners need to know about the management of first episode psychosis in young people.

Dr Shymko outlines the key principles in the management of early psychosis, including the importance of early detection and effective relapse prevention. He describes the gold standard of care as a multidisciplinary, holistic approach, incorporating not only medication management with antipsychotics but also assertive case management, psychological interventions, family support, and wraparound ancillary services such as peer support and vocational guidance.

They also covered the considerations regarding the choice of antipsychotic medication, including the use of newer atypical antipsychotics and long-acting injectable (depot) preparations to improve adherence—particularly in the context of limited insight, which is common in this patient group. 

For GPs, Dr Shymko highlights the ongoing role in supporting the patient’s physical health, addressing issues such as metabolic monitoring, sexual health, and contraception, as well as assisting with broader aspects of care when appropriate.

Links & Resources:

• Orygen - GP Guide to Early Psychosis (free PDF guideline): https://oyh.org.au/our-services/training-resources/free-downloads-youth-mental-health-resources/gp-guide-early
• Orygen - paid training modules (not specifically aimed at GPs, but may be helpful): https://www.orygen.org.au/Training/Resources/Psychosis/Modules
• RACGP Articles:
• https://www1.racgp.org.au/newsgp/clinical/the-importance-of-early-intervention-in-youth-psyc
• https://www.racgp.org.au/afp/2013/september/emerging-psychosis-in-adolescents
• Headspace Early Psychosis Program Information: https://headspace.org.au/services/early-psychosis/

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