[First episode psychoses: psychosocial, interpersonal and cognitive bases for a therapeutic approach]

The occurrence of psychotic symptoms in first episode psychoses is the ultimate stage of a series of behavioural, cognitive and psychosocial signs. Among these, only a small set are pathognomonics, but more importantly, they continue to operate and to modify the clinical picture. The instability of diagnosis and outcome require a large series of multimodal and atheoretical treatment approaches. Interventions should be flexible, acceptable, intrinsically effective and evidence based. Clinical and therapeutic decisional algorithms will be presented to be adopted in mental health services for people at first episode psychoses.