Which symptom is most characteristic of a first episode psychosis?

• A. Hallucinations/delusions
• B. Improved memory
• C. Increased attention
• D. Normal sleep patterns

Answer: (B)

Hallucinations and delusions are the hallmark features of a first episode psychosis. They represent experiences or beliefs that are not grounded in reality and are what clinicians most prominently look for when psychosis first appears.

Other options don’t fit as well: memory improvement and increased attention aren’t characteristic of psychosis and would suggest intact or even enhanced cognition, which isn’t typical in psychotic episodes. Normal sleep patterns also don’t define a first episode, since sleep can be disrupted during psychosis but normal sleep by itself isn’t a distinguishing feature.