First-episode psychosis — MCCQE Part 1 MCQ

Correct answer: B — Refer urgently to an early psychosis intervention programme and assess risk

Refer urgently to an early psychosis intervention programme and assess risk is the single best answer because the age, timing, examination findings and investigations in the vignette fit First-episode psychosis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian schizophrenia guidelines, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian schizophrenia guidelines