The first psychosis is a crucial point for further development of mental disorders. Previous evidence has demonstrated that psychotic disorders, including schizophrenia, are associated with a large number of years living with the disability. It is a global aim to improve prognosis of psychotic disorders, especially in rural regions, where mental health care possibly is not so easily accessible for patients. The aim of this study was to investigate clinical and sociodemographic determinants in association with patient and illness related factors to improve knowledge and understanding of first time psychosis patients in a rural region. This is a descriptive, cohort-based study of all consecutive first episode psychosis (F20, F23, ICD 10) patients admitted in the Daugavpils Psychoneurological Hospital (DPNH) between January 2016 and December 2017. Of the 94 first-time patients hospitalised in DPNH with symptoms of psychosis, 69 met the inclusion criteria. Our results showed that median age of patients was 33 years (IQR 27.5–42.0), median duration of untreated illness (DUI) was 30 months (IQR 11.0–60.0), and median duration of untreated psychosis (DUP) was 8 weeks (IQR 4.0–48.0). The results showed that 55.1% of first psychosis patients had not seen any health care specialist before being admitted to the psychiatric hospital. We found statistically significant differences between some sociodemographic aspects in DUI/DUP. Patients who lived with relatives had the longest DUI — 36 months, compared with 12 months for those who had established their own family. Unemployed patients had longer DUI — 36 months, compared with 12 months for employed patients. Similar findings were shown for associations with DUP. To our knowledge this study adds several important findings that help to better understand first psychosis patients.