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First-episode psychosis — MCCQE Part 1 MCQ

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ModeratePsychosisFirst-episode psychosisMCCQE Part 1

A 21-year-old university student has 3 weeks of auditory hallucinations, persecutory beliefs and social withdrawal. He uses cannabis daily but has no fever, headache or focal neurological signs. He is frightened but cooperative. What is the most appropriate investigation?

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Correct answer: D — Assessment for substance use, medical causes and early psychosis referral

First-episode psychosis requires assessment for substance-induced, medical and primary psychiatric causes, risk assessment, and early psychosis referral. Cannabis can precipitate or worsen psychosis but should not end the assessment. Schizophrenia requires duration and exclusion criteria not yet established here.

Reference: Canadian Schizophrenia Guidelines