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Psychiatry 50 Rapid-Review Facts: The Differences for MRCP Part 1

TL;DR;

Psychiatry questions in MRCP Part 1 frequently test your ability to distinguish between similar conditions rather than recall definitions. This clinician-written rapid review covers the most examined contrasts, classic traps, and drug effects. Use it as a consolidation piece alongside question practice and core notes.


Why psychiatry “difference questions” matter

In the MRCP Part 1 written paper, psychiatry questions are often subtle. Candidates lose marks by confusing overlapping syndromes (for example, delirium vs dementia) or by misattributing psychotropic drug adverse effects. The exam blueprint published by MRCP(UK) emphasises applied clinical reasoning, not textbook definitions.

This article supports the core MRCP Part 1 overview👉 https://www.crackmedicine.com/mrcp-part-1/


Scope of this rapid review

  • Adult psychiatry topics commonly tested in MRCP Part 1

  • Diagnostic comparisons and timelines

  • First-line management principles

  • High-yield psychopharmacology

  • Frequent exam traps

Child psychiatry, psychotherapy theory, and rare syndromes are intentionally excluded.


The 5 most tested psychiatry subtopics

  1. Delirium vs Dementia

  2. Depressive disorders and bipolar illness

  3. Psychotic disorders

  4. Anxiety-related conditions

  5. Psychotropic drug adverse effects


12 high-yield psychiatry differences you must know

1. Delirium vs Dementia

  • Delirium: acute onset, fluctuating course, impaired attention

  • Dementia: insidious onset, stable attention early, progressive decline

Attention impairment is the single most reliable discriminator.

2. Alzheimer disease vs Vascular dementia

  • Alzheimer: gradual, memory-led decline

  • Vascular dementia: stepwise deterioration, focal neurological signs

3. Depression vs Adjustment disorder

  • Depression: ≥2 weeks, biological symptoms (sleep, appetite, energy)

  • Adjustment disorder: emotional response within 3 months of stressor

4. Unipolar vs Bipolar depression

  • Bipolar depression: hypersomnia, hyperphagia, family history

  • Antidepressant monotherapy may precipitate mania in bipolar disorder

5. Schizophrenia vs Schizoaffective disorder

  • Schizophrenia: mood symptoms present <50% of illness duration

  • Schizoaffective disorder: mood symptoms dominate the illness course

6. Positive vs Negative symptoms of schizophrenia

  • Positive: hallucinations, delusions

  • Negative: avolition, anhedonia, flat affect (poor prognosis)

7. Panic disorder vs Generalised anxiety disorder

  • Panic disorder: episodic, sudden, severe autonomic symptoms

  • GAD: persistent anxiety for ≥6 months

8. OCD vs Obsessive-compulsive personality disorder

  • OCD: intrusive thoughts, ego-dystonic

  • OCPD: perfectionism, ego-syntonic

9. PTSD vs Acute stress disorder

  • Acute stress disorder: symptoms <1 month

  • PTSD: symptoms persist >1 month

10. Typical vs Atypical antipsychotics

  • Typical: extrapyramidal side effects

  • Atypical: metabolic syndrome, QT prolongation

11. SSRI vs SNRI adverse effects

  • SSRIs: sexual dysfunction, gastrointestinal upset

  • SNRIs: hypertension, significant withdrawal symptoms

12. Lithium vs Valproate

  • Lithium: tremor, hypothyroidism, nephrogenic diabetes insipidus

  • Valproate: weight gain, hepatotoxicity, teratogenicity

Psychiatry revision setup with notes and MCQs for MRCP Part 1 study

Classic exam table: delirium vs dementia

Feature

Delirium

Dementia

Onset

Acute

Gradual

Course

Fluctuating

Progressive

Attention

Impaired

Preserved early

Consciousness

Altered

Normal

Reversibility

Often reversible

Irreversible

Mini-case (MRCP style)

Question A 78-year-old man becomes confused over 36 hours following admission with urosepsis. He is inattentive, disoriented, and has visual hallucinations. His daughter reports normal cognition one week earlier.

Most likely diagnosis? Delirium

Explanation The acute onset, fluctuating cognition, impaired attention, and precipitating medical illness are diagnostic of delirium. Dementia does not present over hours to days.

For similar questions, practise with real exam-style items:👉 https://www.crackmedicine.com/qbank/


The 5 most common psychiatry traps in MRCP Part 1

  • Missing delirium in hospitalised elderly patients

  • Assuming hallucinations always indicate schizophrenia

  • Forgetting antidepressants can induce mania

  • Confusing OCD with personality traits

  • Ignoring medical causes of psychiatric symptoms

Practical study-tip checklist

  • ☐ Learn one discriminator per diagnosis

  • ☐ Memorise timelines (acute vs chronic vs episodic)

  • ☐ Revise psychotropic adverse effects systematically

  • ☐ Always consider organic causes first

  • ☐ Sit at least one timed mock before the exam

Mock exams available here:👉 https://www.crackmedicine.com/mock-tests/


FAQs (People Also Ask)

Is psychiatry high-yield in MRCP Part 1?

Yes. Psychiatry contributes several questions per diet, commonly through differential diagnosis and drug adverse effects.

What is the single most tested psychiatry topic?

Delirium versus dementia is consistently tested and frequently answered incorrectly.

Do I need DSM or ICD criteria?

No. The exam focuses on clinical features, timelines, and management rather than formal diagnostic manuals.

Which guideline source should I trust for psychiatry revision?

UK-based guidance from NICE is most aligned with MRCP expectations.https://www.nice.org.uk/guidance/conditions-and-diseases/mental-health-and-behavioural-conditions


Ready to start?

Use this article as a rapid-review layer, then consolidate with timed practice from the question bank and a full-length mock test. For a structured roadmap, revisit the MRCP Part 1 overview hub.


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