Background: The typical age of onset for psychotic disorders is concurrent with the typical
age of enrollment in higher education. College and graduate students often experience new academic
and social demands that may leave them vulnerable to substance use and mental health problems,
including the initial onset of a psychotic episode.
Objective: To provide a current overview of the guidelines and literature for the diagnosis and treatment
of early psychosis with special consideration for the college and graduate student population in
the United States. To highlight areas of need and provide recommendations for clinicians who work
at educational institutions and their health services, along with general psychiatrists and psychologists
who work with post-secondary education populations, to help close the treatment gap.
Methods: A review of interventions and best practice for the treatment of early psychosis in college
students was conducted, informed by the authors’ current experience as clinicians working with this
population at a university in the United States.
Results: Thorough psychiatric interviews and screening tools can help in the early identification of
individuals at clinical high risk for, and at the first onset of, psychosis. Coordinated specialty care
services are the gold standard for early psychosis and include psychotherapy interventions (such as
cognitive behavioral therapy and individual resiliency training), as well as support for a student to
return to school or work. Individuals experiencing a first episode of psychosis, in general, respond
better to lower doses of antipsychotics and may also experience more adverse effects.
Conclusion: Return to a high level of functioning is possible in many cases of early psychosis, with
early identification and treatment essential.