People presenting to mental health services within UK MHRN Hubs with a first episode of operationally defined psychosis will be approached for consent. Eligibility criteria will be those people whose disorders meet operational criteria of the World Health Organisation for first contact psychosis. Research assistants will screen NHS casenotes for potentially eligible patients. Assessments at baseline are mainly those already used routinely in early intervention teams around the UK.

Assessments will fall into three domains:

1. Clinical symptoms:

a) operational diagnosis according to DSM4 and ICD10 (OPCRIT); b) Positive and Negative Syndrome Scale (PANSS); c) Young Mania Scale); d) Birchwood Insight Scale (BIS); e) Calgary Depression Scale

2. Risk and protective factors:

a) Standardised family history interview; b) Sociodemographic schedule; c) premorbid adjustment schedule (PAS); d) standardised substance misuse interview (Drug check); e) cognitive function (CANTAB − 3 subtests)f) Drug side effects - EPSE/BARS/ANNSERS

3. Course and outcome:

a) algorithm for estimation of untreated psychosis; b) inital pathways to care assessment; c) Time use activities schedule); d) Global assessment of functional scales; e) MacArthur scale for self harm and violence; f) Quality of Life assessment: EQ5D (Euro−Qol); Engagement assessment; g) Treatment documentation (from casenotes) h) Treatment compliance

Asample of participants will also be given a 5 minute semi−structured interview to assess attitutudes and concerns about possible future data collection to be entered anonymously on to a secure web held database.

Consenting participants will be reassessed at 6 and 12 month follow−up in domains 1 and 3 above, with assessments repeated, plus the following:

a)      service engagement scale, b) estimate of relapse, c) deliberate self−harm index.

If a parent is available and consent is received to approach them, the following assessments will be done:

 a) duration untreated psychosis, b) family history interview.

In summary, a range of demographic and clinical baseline and follow−up assessments will be performed at interview, most of which data are collected routinely in an unstructured way in current mental health services. Assessments will be undertaken at the participant's convenience at home or in a secondary mental health care setting.