skip to main content

First Episode Psychosis — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSchizophrenia & PsychosisFirst Episode PsychosisMRCPsych Paper B

A 30-year-old man has achieved full remission following treatment of his first episode of non-affective psychosis. He asks whether the 2-year period discussed by his psychiatrist refers to the duration of antipsychotic treatment or to follow-up after stopping it. Which plan best reflects NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Continue medication for 1–2 years after the episode; monitor for at least 2 years after withdrawal

Explanation lettering: E = shown as B · B = shown as D · D = shown as E

C is correct. NICE information advises taking antipsychotic medication for 1–2 years after an episode of psychosis to reduce the risk of recurrence; the professional recommendations frame this as a high risk of relapse if medication is stopped during the next 1–2 years. If withdrawal is subsequently agreed, the dose should be reduced gradually and the patient monitored for relapse during withdrawal and for at least 2 years afterward. Thus, the post-withdrawal monitoring period is separate from the continuation-treatment period. Three or 6 months is too short. Treatment for at least 5 years or indefinitely may be appropriate after recurrent episodes or according to individual risk, but is not the routine recommendation following a single first episode in full remission.

Reference: National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (CG178), section ‘Support after an episode’, 2014. https://www.nice.org.uk/guidance/cg178/ifp/chapter/support-after-an-episode