Implementation of the early psychosis outpatient clinic for children and adolescents (PEPIA) in a public psychiatric hospital in northeastern Brazil

An experience report

Abstract

Objective: To describe the creation and initial experience of the Early-Onset Psychosis Outpatient Clinic (PEPIA), implemented in April 2024 at the Professor Frota Pinto Mental Health Hospital (HSMPFP), in Fortaleza, Ceará, Brazil.  Experience Report: PEPIA was established to provide care for children and adolescents under 18 years of age with suspected or confirmed psychosis. The service operates weekly, integrated into the Child and Adolescent Care Center (NAIA), with a team composed of child and adolescent psychiatrists and a resident in training. The clinical flow includes initial diagnostic evaluation, comprehensive laboratory investigation, and individualized clinical follow-up, with the application of the PANSS and WHOQOL-BREF scales. To date, 18 patients have been followed, mainly with diagnoses of schizophrenia and affective disorders with psychotic symptoms. Discussion: The experience demonstrates the feasibility and relevance of a specialized service for early-onset psychosis in childhood and adolescence, reinforcing the importance of early treatment in reducing the duration of untreated psychosis and improving clinical and functional outcomes. PEPIA fills a care gap in Northeastern Brazil, articulating with the Psychosocial Care Network (RAPS) and adopting a multidimensional assessment model with continuous supervision. This initiative shows potential to enhance early diagnosis, strengthen professional training, and contribute to the development of public policies in child and adolescent mental health.