BackgroundIn low-and middle-income countries people with schizophrenia are reported to experience better outcomes than those in high-income countriesAimsTo examine structural brain differences in people with first-episode psychosis and controls in BrazilMethodMagnetic resonance imaging using voxel-based morphometry was performed on 122 people with first-episode psychosis and 94 controlsResultsThere were significant decreases in grey matter in the left superior temporal and inferior prefrontal cortices, insula bilaterally and the right hippocampal region in first-episode psychosis (P<0.05, corrected for multiple comparisons). The subgroup of people with schizophrenia (n=62) exhibited a similar pattern of decrease in grey matter relative to controlsConclusionsStructural abnormalities reported in psychosis in high-income countries are also present in first-episode psychosis in Brazil