Topic module

Psychosis, Cognition and Capacity

Recognise psychosis and cognitive syndromes, exclude physical causes and apply decision-specific capacity principles.

Long-form learning

Concept to Risk to Memory to Check-up

Practise recognising the immediate clinical task, ruling in or out dangerous alternatives, choosing the safest next step and closing the loop.

Core concepts

Concept 1

New psychosis or behavioural change may have medical, substance-related or neurological causes.

Exam cue: Separate immediate risk and organic causes from the longer-term diagnosis.

Concept 2

Capacity is decision- and time-specific and requires practicable support before judging inability.

Exam cue: Apply the relevant legal framework for the UK jurisdiction in the scenario.

Risk pitfalls and guardrails

Equating mental illness or an unwise choice with incapacity.

Guardrail: Avoid an option that names a plausible diagnosis but ignores physiology, contraindications, competence, patient priorities or follow-up.

Missing delirium in a patient labelled as having psychiatric illness.

Guardrail: Avoid an option that names a plausible diagnosis but ignores physiology, contraindications, competence, patient priorities or follow-up.

Memory anchors

What should first-episode psychosis assessment include?

Risk, physical and substance causes, mental state, collateral history and urgent support.

What are the capacity abilities?

Understand, retain, use or weigh relevant information, and communicate the decision.

Does an unwise choice prove incapacity?

No. Capacity concerns the decision-making process, not whether clinicians agree.

How is delirium distinguished from primary psychosis?

Acute fluctuation, impaired attention and an underlying physical cause point to delirium.

What follows a capacity finding?

Document the decision, support used, evidence and the lawful next step.

Checkpoint rule

Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.

Knowledge Check (after reading)

Short check-up to confirm understanding of this module.

1-2 question checkpoint

A patient with first-episode psychosis is febrile, tachycardic and disoriented. What is the priority?

A patient hears voices, is socially withdrawn and has deteriorated for two months. What is best?

Answer all questions to submit.

Next step personalized recommendations

Move forward only after this module is stable.

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