The aim of this study was to investigate clinico-psychopathological peculiarities in patients with the first psychotic episode (FPE) to ameliorate their therapy. 124 patients with FPE were examined. In this examination the clinico-psychopathological, pathopsychological and statistical methods were used.

It was found out that an average age of the episode development was 26.3±5.2 years, an average duration of the episode was 389±47.9 days, and a preliminary usage of neuroleptics was determined in 79.2% of cases.

The most frequent symptoms in these patients were lack of insight, ideation of reference, suspiciousness, delusional mood, thought alienation, thought echo.

In patients with FPE negative manifestations such as flattening of affect, illogical features, apathy, unhedonia, unsociability, attention disorders were pointed out.

A typical syndromal structure of a manifested psychotic attack expressed with the hallucinatory-paranoid (53.9%), paranoid (24.8%), depressive-paranoid (18.8%), and maniacal-paranoid (2.4%) syndromes.

In patients with FPE it was registered a worsening of cognitive functions such as attention, a verbal and operative memory, executive functions, that was combined with local changes of the brain volume.

A treatment for patients with FPE involved pharmacological strategies, a psychosocial therapy and a psychosocial rehabilitation. Atypical antipsychotics are the first line medications in treatment of these patients. A choice of antipsychotic was discussed with a patient and his/her relatives. Basic methods of a psychosocial rehabilitation were mental health educative activities, family therapy, group social therapy, a training of social skills and cognitive functions, social occupational therapy.