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High-Yield Psychiatry for MRCP Part 1

TL;DR: 

Psychiatry is a small but reliable scoring area in MRCP Part 1. Questions focus on core diagnoses, drug adverse effects, delirium–dementia differentiation, and capacity. This article outlines the examinable scope, high-yield facts, common traps, one MCQ-style case, and a practical revision checklist.


Why psychiatry matters in MRCP Part 1

Psychiatry typically contributes a modest proportion of the written paper, but the yield is disproportionately high. Questions are rarely esoteric. Instead, they test definitions, timelines, and adverse-effect recognition, often embedded in short clinical vignettes. Candidates lose marks by confusing similar syndromes (e.g. delirium vs dementia) or by misattributing medication side effects.

This article supports structured revision within the main MRCP Part 1 overview:👉 https://crackmedicine.com/mrcp-part-1/


Scope of psychiatry in MRCP Part 1

The exam blueprint (MRCP(UK)) emphasises applied clinical knowledge rather than psychotherapy theory.

Commonly examined areas

  • Descriptive psychopathology

  • Major psychiatric disorders (ICD-10 style concepts)

  • Psychopharmacology and adverse effects

  • Capacity, consent, and basic medico-legal principles

  • Psychiatry in medical illness (delirium, depression in chronic disease)

Authoritative references you should align with:


10 high-yield psychiatry facts examiners expect you to know

  1. Delirium is acute, fluctuating, and characterised by impaired attention with an underlying medical cause.

  2. Dementia is chronic and progressive with preserved consciousness until late stages.

  3. Schizophrenia requires ≥1 month of characteristic symptoms and ≥6 months of functional disturbance.

  4. Negative symptoms predict poorer prognosis than positive symptoms.

  5. SSRIs commonly cause hyponatraemia due to SIADH, particularly in older adults.

  6. Tricyclic antidepressants are dangerous in overdose due to sodium-channel blockade and arrhythmias.

  7. Lithium adverse effects include tremor, hypothyroidism, nephrogenic diabetes insipidus, and teratogenicity.

  8. Neuroleptic malignant syndrome (NMS) presents with rigidity, hyperthermia, autonomic instability, and raised CK.

  9. Serotonin syndrome causes hyperreflexia, clonus, agitation, and diarrhoea.

  10. Capacity is decision-specific and time-specific; an unwise decision does not equal incapacity.


The 5 most tested psychiatry subtopics

1. Delirium vs dementia

A perennial favourite. Delirium has acute onset, fluctuating course, impaired attention, and a precipitating illness or drug. Dementia is gradual and non-fluctuating.

2. Mood disorders

Know diagnostic thresholds for major depressive disorder and bipolar affective disorder. Antidepressant monotherapy can precipitate mania in bipolar patients.

3. Schizophrenia and psychosis

Focus on duration criteria, first-rank symptoms, and antipsychotic adverse effects (EPS, hyperprolactinaemia, metabolic syndrome).

4. Psychopharmacology

This is the highest-yield area. Questions test drug–side-effect pairs, interactions, and contraindications in comorbid medical disease.

5. Capacity and consent

Understand the four elements of capacity: ability to understand, retain, weigh, and communicate information.


MRCP Part 1 psychiatry revision setup with textbooks and study notes

Common exam traps (5 to avoid)

  • Confusing delirium with dementia → always assess attention and time course.

  • Mislabeling NMS as sepsis → look for rigidity and raised CK.

  • Assuming all lithium tremor equals toxicity → mild tremor can occur at therapeutic levels.

  • Treating capacity as global → it is decision-specific.

  • Ignoring medical causes of depression → e.g. hypothyroidism, Parkinson disease.


Mini-case / MCQ

A 74-year-old man becomes acutely confused 48 hours after admission for urosepsis. He is inattentive, disoriented, and worse at night. What is the most likely diagnosis?

A. Alzheimer diseaseB. Vascular dementiaC. DeliriumD. Late-onset schizophreniaE. Major depressive disorder

Correct answer: C — Delirium

Explanation: Acute onset, fluctuating cognition, impaired attention, and a clear medical precipitant are classic for delirium.

Practise similar exam-style questions here:👉 https://crackmedicine.com/qbank/And test timing under pressure with full papers:👉 https://crackmedicine.com/mock-tests/


Practical psychiatry revision checklist

  • □ Memorise definitions and timelines (delirium, schizophrenia, depression).

  • □ Build a drug–adverse-effect table for antidepressants, antipsychotics, lithium.

  • □ Practise vignette discrimination (delirium vs dementia).

  • □ Learn capacity criteria verbatim.

  • □ Use mixed mock tests to integrate psychiatry with neurology and pharmacology.

Targeted teaching can further consolidate these areas:👉 https://crackmedicine.com/lectures/


FAQs

How many psychiatry questions appear in MRCP Part 1?

Usually around 5–8% of the paper. The content is predictable and high yield.

Is psychotherapy theory required for MRCP Part 1?

No. The exam focuses on diagnosis, medication, and legal principles.

What is the single highest-yield psychiatry topic?

Psychopharmacology, particularly adverse effects and toxicity.

Do I need detailed Mental Health Act sections?

No. Only general principles such as capacity and consent are tested.


Ready to start?

Use this guide as a framework, then reinforce it with timed questions from the MRCP Part 1 overview pathway, targeted Free MRCP MCQs, and revision-focused lectures


Sources

 
 
 

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