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Mania — MCCQE Part 1 MCQ

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ModeratePsychosisManiaMCCQE Part 1

31-year-old man presents with decreased need for sleep and grandiose plans. He is spending excessively, pressured and irritable for 10 days. Which of the following is the most appropriate next step?

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Correct answer: E — Diagnose mania and arrange urgent psychiatric treatment, considering admission if risk is high

Diagnose mania and arrange urgent psychiatric treatment, considering admission if risk is high is best because elevated/irritable mood with impairment and decreased sleep suggests mania. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Antidepressant monotherapy can worsen bipolar illness.

Reference: CANMAT bipolar disorder guidelines