With typical onset in late adolescence or young adulthood psychosis often have a chronic and relapsing course with potentially devastating functional implications. Research on the period that precedes the modal age of onset psychosis has become crucial for identifying the very early stage

This study aims to determine the pre-admission clinical, socio-demographic characteristics and prodromes associated to a first psychotic episode

It's a retrospective observational study. Fifty five Tunisian patients admitted in Hedi Chaker hospital between 2007 and 2013 were recruited. Socio-demographic and clinical data were collected and patients were diagnosed using DSM-IV criteria.

The mean age was 26.5. 61.8 %lived in a rural environment.

54.5% had a family history of psychiatric disorder. 12.7% had a history of head trauma

74.5% were schizoid, 1.8 % had avoidant personality disorder, and 1.8% had schizotypal personality disorder

10.9% suffered from irritability. 67.3% had anxiety .38.2% suffered from depression. 20% experienced mood fluctuations

29.1% had frequent fatigue; 10.9% had a loss of interest

18.2% complained about difficulties with concentration, 10.9% had difficulties of recall

14.5% had loss of appetite, 78.2% suffered from sleep disturbance, 23.6 % lost weight.

25.5% had marked impairment in personal hygiene and grooming .70.9% presented social isolation and withdrawal .7.3% had Impairment in role functioning .40% had odd believes.

Since there is a variety of unspecific signs which may precede a first psychotic episode and no specific biological markers; treating even with insufficient evidence may sometimes become an alternative.