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First-episode psychosis — MCCQE Part 1 MCQ

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ModeratePsychosisFirst-episode psychosisMCCQE Part 1

A 20-year-old university student has 2 months of auditory hallucinations, persecutory delusions and declining function. He is not intoxicated and has no delirium. Which of the following is the most appropriate next step?

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Correct answer: B — Arrange urgent early-psychosis assessment with risk, substance and medical evaluation

Two months of hallucinations, delusions and functional decline is a first-episode psychosis presentation. Urgent specialist early-intervention assessment reduces untreated duration and should occur alongside immediate evaluation of suicide and violence risk, self-care, substance use, medications and medical causes. Antipsychotic treatment may begin promptly after assessment, but involuntary admission depends on risk and applicable law, not diagnosis alone.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC5593252/; https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/psychosis