A 23-year-old man presents with a 6-month history of social withdrawal, auditory hallucinations and persecutory delusions. He has no prior psychiatric...

Question

A 23-year-old man presents with a 6-month history of social withdrawal, auditory hallucinations and persecutory delusions. He has no prior psychiatric history. Physical examination and basic investigations are unremarkable. What is the most appropriate initial management?

Accepted Answer

Start a single second-generation antipsychotic at a low dose and refer to an early psychosis intervention service.

Answer

Start two antipsychotics at full doses to ensure rapid response.

Answer

Prescribe benzodiazepines only for anxiety.

Answer

Delay treatment until symptoms persist for 1 year to confirm chronicity.

Answer

Use high-dose first-generation antipsychotic as first-line to test response.

ca-mccqe1 MCQ (SBA): First-episode psychosis

A 23-year-old man presents with a 6-month history of social withdrawal, auditory hallucinations and persecutory delusions. He has no prior psychiatric history. Physical examination and basic investigations are unremarkable. What is the most appropriate initial management?