AMC psychiatry MCQ questions
Mental health, including addiction, is 12.5% of the AMC CAT MCQ, about 19 of 150 questions. Most marks turn on excluding a medical cause first, first-line treatment and mental health law.
Updated 28 September 2026 · Checked against the sources listed below
AMC CAT MCQ at a glance
- patient groups in the blueprint
- 6
- questions in one sitting
- 150
- per question on average
- 84 s
- on the 0 to 500 scale to pass
- 250
Psychiatry · 8 questions
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Question 1 · Substance use and addictive disorders
A 38-year-old man tells his general practitioner he bets on sports apps most nights. Over 2 years he has needed bigger bets for the same thrill, bets again to win back losses and has hidden $40,000 of debt from his partner. He has no depressive symptoms or suicidal thoughts.
Which one of the following is the most appropriate management?
Question 2 · Special populations and psychological therapies
A 31-year-old man asks his general practitioner to assess him for ADHD. He describes long-standing disorganisation, missed deadlines, losing things, restlessness in meetings and impulsive spending, causing problems at work and at home. He had an episode of depression at 25 that resolved with treatment, and his mood is now normal. His brother was diagnosed with ADHD as a child.
Which one of the following findings would most strongly support a diagnosis of ADHD?
Question 1 · Mood disorders
A 58-year-old man attends his general practitioner 14 months after his wife died at home, under palliative care, from bowel cancer diagnosed 2 years earlier. He describes an intense longing for her that has not eased and says he still cannot accept that she has died. He has stopped seeing friends and has not returned to work. His distress centres on her loss: he still enjoys time with his grandchildren, and his sleep and appetite are normal. He has no nightmares or intrusive memories of her death.
Which one of the following is the most likely diagnosis?
Question 4 · Mood disorders
A 68-year-old woman with a history of major depression is admitted to a mental health unit. Over the past 2 weeks she has stopped eating and drinking because she believes her internal organs have 'stopped working' and that eating is pointless. She has lost 6 kg. She has not responded to an adequate 8-week trial of sertraline.
Which one of the following is the most appropriate management?
Question 5 · Psychotic disorders
A 19-year-old man with no past psychiatric history is brought to the emergency department by his family after 5 days of new persecutory beliefs that neighbours are plotting against him, and auditory hallucinations telling him he is in danger. He is alert and oriented, with no history of fever, head injury or known substance use. Physical examination is unremarkable.
Which one of the following is the most appropriate initial management?
Question 6 · Psychotic disorders
A 24-year-old man has experienced persecutory delusions and auditory hallucinations for the past 8 months, with negative symptoms such as social withdrawal. There is no history of a recent major stressor, his mood has been neither elevated nor persistently low, and his symptoms have not resolved. He does not use alcohol or other drugs, and a urine drug screen is negative.
Which one of the following is the most likely diagnosis?
Question 7 · Risk assessment, emergency psychiatry and mental health law
A 42-year-old man with schizophrenia is brought to the emergency department by his sister because he has become agitated and confused over 2 days. He says people are watching him, which she says is like his previous relapses. He fell from a ladder 2 days ago and has vomited three times since. His temperature is 37.1°C, pulse 100/min, blood pressure 150/88 mmHg, respiratory rate 18/min, oxygen saturation 97% breathing room air and capillary glucose 5.4 mmol/L. Glasgow Coma Scale score is 14 (E4 V4 M6). There is a bruise over the left temple. He is calmer after verbal de-escalation.
Which one of the following is the most appropriate next step in management?
Question 8 · Mood disorders
A 15-year-old boy is brought to his general practitioner by his mother, who reports he has become increasingly withdrawn over the past 3 months, his grades have dropped significantly, and he has stopped seeing friends. He denies feeling sad when asked directly but appears irritable and gives short answers.
Which one of the following is the most likely diagnosis?
AMC CAT MCQ at a glance
- patient groups in the blueprint
- 6
- questions in one sitting
- 150
- per question on average
- 84 s
- on the 0 to 500 scale to pass
- 250
What the AMC tests in mental health
The AMC's examination specifications describe mental health as the assessment, diagnosis and management of psychological, behavioural and mental disorders and illnesses and addictions across all age groups, on biopsychosocial and cognitive principles. That includes the history, mental state examination, investigations and comorbidities, and management with psychological, behavioural, physical and drug treatment, with their risks and benefits.
The questions on this page cover mood disorders, psychotic disorders, anxiety and trauma, risk and emergency psychiatry, substance use, personality, eating and somatic disorders, neurocognitive disorders and mental health in children, older people, refugees and people with intellectual disability.
Where it sits in the exam
Mental health is 12.5% of the blueprint, about 19 of the 150 questions. It overlaps with adult medicine in toxicology, delirium and withdrawal, with women's health in the perinatal period and with population health in consent, capacity and mental health law.
Where candidates go wrong
These traps recur in our question bank.
- A psychiatric label before a medical cause is excluded. An agitated, confused patient has a blood glucose checked early. First-episode psychosis needs assessment for delirium, substances, thyroid disease, brain lesions and infection before an antipsychotic is started.
- Sedation before de-escalation. Verbal de-escalation comes first, then oral sedation if needed, with parenteral sedation and restraint only when less restrictive steps have failed.
- A tablet where therapy is first-line. Chronic insomnia is treated first with cognitive behavioural therapy for insomnia, post-traumatic stress disorder with trauma-focused therapy and obsessive-compulsive disorder with exposure and response prevention alongside an SSRI. Long-term benzodiazepines for anxiety are avoided.
- Diagnosis before its time. Symptoms in the first month after trauma fit acute stress disorder. Mania needs the duration and severity of the high to be established.
- Confusing the toxic syndromes. Clonus, hyperreflexia and agitation after two serotonergic drugs point to serotonin toxicity rather than neuroleptic malignant syndrome.
- Missing the antidepressant switch. New manic symptoms on an antidepressant mean stopping it, not treating presumed depression harder.
- Stopping short of clozapine. After two adequate antipsychotic trials with confirmed adherence, clozapine is the recommended next step.
- Reading a positive EPDS item 10 as tiredness. Any positive answer to the self-harm question calls for immediate assessment.
How to revise mental health
Learn each disorder by three questions the exam asks: what has to be excluded first, what the diagnostic time frame is and what the first-line treatment is in Australia. Most wrong options are the second-line treatment, a diagnosis made too early or a psychiatric label that skipped a medical cause.
Lithium and clozapine carry monitoring rules that questions test directly. Local protocols differ in detail; these figures come from Western Australian health service guidelines.
| Drug and decision | Standard | Source |
|---|---|---|
| Lithium level in acute mania | 0.8 to 1.2 mmol/L, taken 12 hours after the dose | WACHS lithium guideline, 2026 |
| Lithium level in maintenance | 0.4 to 1 mmol/L; 0.4 to 0.6 mmol/L in older people | WACHS lithium guideline, 2026 |
| When to check lithium | 5 to 7 days after starting or any dose change, then every 3 months once stable | WACHS lithium guideline, 2026 |
| Lithium toxicity | Usually above 1.5 mmol/L, and within the usual range in some older people. Vomiting, diarrhoea and ataxia progress to coarse tremor, hyperreflexia, confusion and seizures | WACHS lithium guideline, 2026 |
| Drugs that raise lithium levels | NSAIDs, ACE inhibitors, angiotensin II receptor blockers, and thiazide and loop diuretics | WACHS lithium guideline, 2026 |
| Clozapine blood counts | Weekly for the first 18 weeks, then monthly | WA clozapine guidelines, 2024 |
| Clozapine and neutropenia | White cell count under 3.0 or neutrophils under 1.5 × 10⁹/L: withhold clozapine and repeat the count | WA clozapine guidelines, 2024 |
| Clozapine and myocarditis | Troponin, CRP, eosinophils and ECG at baseline and on days 7, 14, 21 and 28; most cases arise in the first 4 weeks | WA clozapine guidelines, 2024 |
The Royal Australian and New Zealand College of Psychiatrists publishes clinical practice guidelines for mood disorders, schizophrenia, eating disorders and self-harm. Therapeutic Guidelines covers psychotropic prescribing and withdrawal management. The AMC's free book Australian Medicine in Context covers common mental health presentations in their Australian setting. Mental health links with adult medicine for toxicology and withdrawal, and with population health and ethics for consent and capacity.
Questions candidates ask
The AMC blueprint gives Mental health 12.5% of the 150 questions, which is about 19. They are randomised with the other patient groups rather than set in a block.
Yes. The AMC describes mental health as psychological, behavioural and mental disorders and illnesses and addictions across all age groups, so alcohol withdrawal, opioid dependence and stimulant use belong here.
Each state and territory has its own mental health Act, so questions test the principles they share: involuntary care only when the criteria are met and no less restrictive option will do, and authority to treat the mental illness itself, not an unrelated physical illness.
No. Risk scales and categories do not predict suicide accurately and should not decide care on their own. Assessment asks directly about thoughts, plans, intent, access to means, past attempts and protective factors, and asking directly does not raise the risk.
Sources
- AMC: Multiple Choice Question Examination Specifications, V8 (September 2025)Checked 28 September 2026
- RANZCP: Clinical guidelines and publications libraryChecked 28 September 2026
- Therapeutic Guidelines Limited: Therapeutic Guidelines (eTG complete)Checked 28 September 2026
- AMC: Australian Medicine in ContextChecked 28 September 2026
- WA Country Health Service: Specialised medication, lithium guideline (version 4.01, June 2026)Checked 28 September 2026
- WA Department of Health: Guidelines for the safe and quality use of clozapine therapy in the WA health system (version 2, June 2024)Checked 28 September 2026
AMC Preparation is independent of the Australian Medical Council. Rules, dates and fees can change: the AMC is the authority, and this page is checked against it.
Check mental health against the rest of the blueprint
The free diagnostic asks 12 questions across all six patient groups in about 14 minutes and gives a first read on every subject, including mental health.
12 questions · about 14 minutes · free, no card details