Table 1.

Themes and recommendations

Theme	Recommendation
1. Strategic engagement of patients with recent‐onset psychosis is important to the success of subsequent care	Treating positive symptoms with a reactive admission‐based approach and little or no follow‐up is a suboptimal approach. It is not enough to manage an episode of psychosis as an isolated event. Once a patient is discharged, ongoing continuity of community care, together with consistency within the treatment team, where possible, are crucial. This approach will facilitate a deeper level of engagement with the patient and their family and a greater understanding of the patient's individual needs and broader issues, thereby assisting with the selection of optimum interventions to promote continued recovery. This theme reflects a need for willingness, on the part of patients, HCPs and families, to engage in continuous and monitored treatment and acknowledges the importance of a combined approach that includes both family members and HCPs.
2. Effective symptom control in recent‐onset psychosis can usually be achieved with antipsychotics	While we acknowledge that the availability, cost, and reimbursement status of different antipsychotics varies throughout the A‐P region, patients and their families should be informed of the pharmacological treatment options available to them including possible AEs.
3. Restoring psychosocial function in recent‐onset psychosis is an essential component in recovery	Remission and recovery are achievable for many patients providing they are well informed, adequately treated, and closely monitored. The expectations of patients and their caregivers should be taken into account when evaluating remission and recovery, together with a realistic and culturally sensitive outlook provided by the HCP.
4. Medication adherence is a critical contributor to relapse reduction in recent‐onset psychosis	Adherence to medication is crucial in preventing relapse and improving outcomes in schizophrenia. Patients should be warned of the dangers of stopping their medication and that they may be required to keep taking medication despite improvement in their symptoms. Care should be taken by HCPs when conveying this information as poor timing and/or bad phrasing can reduce the patient's willingness to comply. Interventions that directly improve adherence behavior, especially those that target substance abuse and depressive symptoms, should be developed. Measures to improve patient insight could be a specific target of treatment in early intervention programs.
5. Long‐acting injectable antipsychotics should be considered in recent‐onset schizophrenia	While we acknowledge that there is a need for a large‐scale, randomized controlled trial comparing oral and LAI APs in recent‐onset psychosis, to assess long‐term outcomes, we believe LAI APs may play a role in relapse prevention via increased rates of adherence and should be considered as an early stage treatment. LAI APs are frequently perceived by patients and family members as an indication that the patient has a severe mental illness and are therefore reluctant to use them. However, many first‐episode patients respond well to LAI APs and, once provided with balanced information, are open to their use.
6. Psychosocial interventions contribute much to desirable clinical outcomes in recent‐onset psychosis	A number of culturally adapted psychosocial therapies are now available throughout the A‐P region. Psychosocial therapies, together with continuous antipsychotic therapy, facilitate recovery and improve adherence to treatment, thereby offering significant benefits to recent‐onset patients in social and vocational aspects. Psychosocial therapies should be implemented early to prevent deterioration of psychosocial and cognitive functions.
7. Involvement of families and carers is an integral part of comprehensive patient management in recent‐onset psychosis	As already highlighted in themes 1, 2, and 6, family members and carers play an important role in supporting patients with medication adherence and day‐to‐day tasks. Stigma may prevent patients and family members seeking help during the early stages of the disease and beyond. Efforts should be made to reduce stigmatizing behavior within health care services and society as a whole particularly in countries where there is strong stigma attached to mental illness. The sociocultural context is important to take into account in discussions with family members.
8. Substance abuse in recent‐onset psychosis impacts negatively on outcomes and needs to be addressed	Comorbid substance abuse can worsen symptoms and outcomes and is a growing problem in the A‐P region, despite the variability in the rates and types of substances abused. The negative contribution that illicit drugs and alcohol make to the course of the illness, not least the legal complications, including a heightened risk of incarceration should be emphasized early in the treatment pathway. Patients should be offered interventions that address comorbid substance abuse in a culturally sensitive manner.
9. Psychiatric comorbidities are common and should be addressed in recent‐onset psychosis	Psychiatric comorbidities such as depression and anxiety disorders can have a negative impact on outcomes. We recommend that psychiatric comorbidities be given high priority during treatment planning in the context of the socioeconomic and cultural background.
10. Medical comorbidities are common and should be monitored and addressed fastidiously in recent‐onset psychosis	Psychiatrists should be conscious of the physical conditions and metabolic issues associated with the use of antipsychotic drugs and the potential for antipsychotic therapies to worsen existing conditions such as diabetes and compromised lipid metabolism. Strategies to improve health and well‐being should be promoted early on, and all patients should be screened regularly for metabolic abnormalities.

AE, adverse event; A‐P, Asia‐Pacific; HCP, healthcare professional; LAI AP, long‐acting injectable antipsychotic.