skip to main content

Self-Harm and Alcohol — MRCPsych Paper B MCQ

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

ModerateLiaison PsychiatrySelf-Harm and AlcoholMRCPsych Paper B

A liaison psychiatrist assesses a 45-year-old woman following an intentional overdose. Her blood alcohol concentration is 150 mg/dL, but she is alert, speaks coherently and is able to engage meaningfully in the interview. According to NICE NG225, what is the most appropriate approach to psychosocial assessment?

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

Reveal the answer and explanation

Correct answer: A — Proceed without using her blood alcohol concentration as a threshold

The correct answer is A. NICE NG225 states that breath or blood alcohol levels should not be used to delay psychosocial assessment after self-harm. This patient is alert, coherent and able to engage meaningfully, so the measured alcohol concentration is not a reason to postpone assessment. There is no requirement to wait for a concentration of zero or below the drink-driving threshold, making A and E incorrect. Assessment should not routinely be deferred until the next day, so D is also incorrect. Clinical ability to participate remains important, but complete resolution of every sign of intoxication is unnecessary, excluding C. If intoxication made the patient unable to participate meaningfully, she should instead receive regular reviews and undergo psychosocial assessment as soon as she became able to engage; no fixed alcohol threshold should be applied.

Reference: National Institute for Health and Care Excellence. Self-harm: assessment, management and preventing recurrence (NG225), recommendations 1.5.3–1.5.5, 2022. https://www.nice.org.uk/guidance/ng225/chapter/recommendations