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2026 Statistics

Key Facts: Facharzt FMH Psychiatrie und Psychotherapie Exam

FAP I + FAP II

Exam Format

SIWF / SGPP Examination Regulations

100+ MCQs

Written FAP I Questions

SGPP Examination Committee

6 Years

Postgraduate Training

SIWF Weiterbildungsprogramm

180 min

Written FAP I Duration

SGPP Examination Standard

Lifetime

FMH Title Validity

Swiss Medical Association (FMH)

100

Practice Questions

OpenExamPrep

The Facharzt FMH Psychiatrie und Psychotherapie credential certifies specialist psychiatrists and psychotherapists in Switzerland through SIWF and SGPP. Examination assessment consists of the written FAP I MCQ examination and the FAP II psychotherapy case thesis defense, spanning clinical psychopathology, psychopharmacology, psychotherapy models, emergencies, and Swiss adult protection law (KESB/FU).

Sample Facharzt FMH Psychiatrie und Psychotherapie Practice Questions

Try these sample questions to test your Facharzt FMH Psychiatrie und Psychotherapie exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 54-year-old bank executive presents with a 7-week history of profound pervasive low mood, distinct lack of emotional reactivity, waking daily at 03:30 (more than 2 hours before his usual alarm) with severe morning exacerbation of depressive symptoms, psychomotor retardation, marked anorexia with a 6 kg weight loss, and excessive feelings of guilt regarding minor administrative oversights at work. He denies psychotic symptoms. According to ICD-10 (F32.2) and DSM-5 criteria, what is the most accurate diagnostic specification for this episode?

A.Major depressive episode with melancholic features (somatic syndrome)

B.Major depressive episode with atypical features

C.Persistent depressive disorder (dysthymia) with anxious distress

D.Bipolar II disorder in a mixed depressive episode

Explanation: The clinical presentation is classic for a major depressive episode with melancholic features (termed 'somatic syndrome' in ICD-10). Cardinal criteria include complete loss of pleasure/reactivity to pleasurable stimuli, distinct quality of depressed mood, profound morning worsening, early morning awakening (terminal insomnia), psychomotor retardation or agitation, significant anorexia/weight loss, and excessive guilt.

2A 42-year-old woman with unipolar major depressive disorder has failed to achieve clinical remission despite sequential 8-week trials of escitalopram (20 mg/day) and venlafaxine extended-release (225 mg/day), both taken with verified therapeutic compliance and confirmed therapeutic plasma levels on therapeutic drug monitoring (TDM). She meets criteria for Treatment-Resistant Depression (TRD). According to Swiss Society of Psychiatry and Psychotherapy (SGPP) and WFSBP guidelines, which evidence-based pharmacological strategy has the highest level of empirical evidence for next-step augmentation?

A.Switching to a third selective serotonin reuptake inhibitor (e.g., sertraline 100 mg/day)

B.Augmentation with Lithium (target serum trough level 0.6–0.8 mmol/L) or a low-dose second-generation antipsychotic (e.g., aripiprazole)

C.Adding high-dose buspirone (60 mg/day) monotherapy

D.Initiating long-term oral benzodiazepine therapy with clonazepam (2 mg/day)

Explanation: Treatment-resistant depression (TRD) is defined as failure of at least two adequate trials of different antidepressant classes at therapeutic doses and durations. Lithium augmentation (targeting serum trough levels of 0.6–0.8 mmol/L) and second-generation antipsychotic augmentation (specifically aripiprazole, quetiapine, or brexpiprazole) represent the pharmacological strategies with the strongest empirical evidence (Level 1A) in SGPP, DGPPN, and WFSBP guidelines.

3A 38-year-old man with treatment-resistant unipolar depression is being evaluated for intranasal esketamine (Spravato) therapy in a Swiss psychiatric outpatient clinic. Which of the following clinical monitoring requirements and Swissmedic-approved administration protocols is mandatory during each treatment session?

A.Self-administration at home without supervision provided a family member is present

B.Continuous invasive arterial line blood pressure monitoring for 24 hours in an intensive care unit

C.Direct administration in a certified medical facility under healthcare professional supervision, with mandatory blood pressure monitoring before dosing, at ~40 minutes, and until clinical stability at ~120 minutes post-dose

D.Concurrent initiation of high-dose intravenous propofol to maintain general anesthesia

Explanation: Swissmedic and EMA regulations mandate that esketamine nasal spray must be administered directly in a healthcare setting under the supervision of a healthcare professional. Blood pressure must be assessed prior to administration, at approximately 40 minutes post-dose (the peak hemodynamic effect), and the patient must be monitored for at least 120 minutes until blood pressure, sedation, and dissociative symptoms have resolved before discharge.

4A 29-year-old man is brought to the emergency department by the police after climbing onto the roof of a municipal building in Zurich, shouting that he has been appointed by the federal council to eliminate the national debt. He has slept 1 hour per night for 6 days, speaks with intense pressure, displays racing thoughts and grandiosity, and has spent CHF 45,000 on luxury watches within 48 hours. Physical exam and drug screen are negative. According to SGPP and CANMAT guidelines, what is the most appropriate first-line pharmacotherapeutic approach?

A.Initiate sertraline 50 mg/day combined with zolpidem 10 mg at bedtime

B.Administer oral citalopram 20 mg/day with intensive dynamic psychotherapy

C.Initiate low-dose lamotrigine 25 mg/day monotherapy

D.Initiate an atypical antipsychotic (e.g., olanzapine, quetiapine, or aripiprazole) either as monotherapy or combined with a mood stabilizer (e.g., lithium or valproate)

Explanation: The patient presents with severe acute mania with psychotic features (Bipolar I disorder). First-line treatment for acute mania consists of a second-generation antipsychotic (e.g., olanzapine, quetiapine, aripiprazole, risperidone) or a mood stabilizer (lithium, valproate), with combination therapy (antipsychotic + mood stabilizer) recommended for severe mania with psychosis to achieve rapid antimanic control.

5A 34-year-old woman presents with severe fatigue, profound anhedonia, hypersomnia, and feelings of worthlessness for 4 weeks. Careful psychiatric history reveals two previous distinct 4-day episodes of elevated mood, decreased need for sleep, uncharacteristic talkativeness, and increased goal-directed productivity that did not cause hospitalization or psychotic symptoms. She is diagnosed with Bipolar II disorder, current episode depressed. Which of the following pharmacotherapies has the strongest evidence-based indication as first-line monotherapy for acute bipolar II depression?

A.Quetiapine (300 mg/day)

B.Escitalopram monotherapy

C.Haloperidol (10 mg/day)

D.Venlafaxine monotherapy

Explanation: Quetiapine (300 mg/day extended-release or immediate-release) has robust Level 1 evidence (EMBOLDEN I & II trials) and guideline approval as first-line monotherapy for acute bipolar depression (both Bipolar I and Bipolar II). Other established options include lurasidone, lumateperone, and the olanzapine-fluoxetine combination.

6A 48-year-old man with bipolar I disorder has been stabilized on lithium carbonate for 3 years without relapse. He attends his routine outpatient follow-up. According to international and Swiss psychiatric standards, what is the recommended timing for drawing blood to measure the 12-hour standardized serum lithium trough concentration, and what is the optimal target therapeutic range for long-term maintenance?

A.Immediately 1 hour after the morning dose, targeting a peak concentration of 1.5–2.0 mmol/L

B.Exactly 12 hours after the evening dose, targeting a serum trough concentration of 0.6–0.8 mmol/L

C.At any random time during clinic hours, targeting a concentration of 0.2–0.4 mmol/L

D.24 hours after holding medication for 3 consecutive days, targeting 1.0–1.4 mmol/L

Explanation: Standardized therapeutic drug monitoring for lithium requires blood sampling exactly 12 hours (± 30 minutes) after the last oral dose (the 12-hour trough level). For long-term bipolar maintenance, the optimal target therapeutic window is 0.6–0.8 mmol/L (or 0.4–0.6 mmol/L in fragile/elderly patients or for well-stabilized responders with tolerability issues; 0.8–1.1 mmol/L during acute mania).

7A 58-year-old patient who has taken lithium carbonate for 15 years presents for annual laboratory surveillance. Which set of organ systems is most susceptible to chronic lithium-induced toxicity and mandates routine laboratory monitoring (e.g., every 6–12 months)?

A.Coagulation factors (PT/INR, aPTT) and ophthalmological intraocular pressure

B.Pulmonary function (spirometry, DLCO) and serum amylase/lipase

C.Renal function (eGFR, serum creatinine, electrolytes), thyroid function (TSH, free T4), and serum calcium/parathyroid function

D.Hepatic transaminases (AST/ALT) and skeletal bone mineral density only

Explanation: Chronic lithium therapy is associated with well-documented adverse effects on the kidneys (nephrogenic diabetes insipidus, chronic tubulointerstitial nephritis leading to decreased eGFR), the thyroid gland (primary hypothyroidism, goiter in 10–20% of patients), and the parathyroid glands (hyperparathyroidism with hypercalcemia). Routine monitoring of eGFR, creatinine, electrolytes, TSH, and calcium is standard.

8A 65-year-old woman on chronic lithium maintenance (0.8 mmol/L baseline) was recently prescribed hydrochlorothiazide and ibuprofen for hypertension and osteoarthritis by her general practitioner. She is admitted to the emergency department with severe coarse tremor, ataxia, dysarthria, hyperreflexia, confusion, and oliguria. Serum lithium level returns at 3.4 mmol/L, with creatinine elevated at 280 mcmol/L (eGFR 16 mL/min). What is the definitive emergency management of choice?

A.Oral administration of activated charcoal and 500 mL of tap water

B.Intravenous loop diuretics (furosemide 80 mg IV) combined with sodium bicarbonate infusion

C.Subcutaneous flumazenil infusion and observation

D.Immediate nephrology consultation for urgent hemodialysis alongside aggressive isotonic intravenous saline rehydration

Explanation: The patient has severe life-threatening acute-on-chronic lithium toxicity (>3.0 mmol/L) precipitated by drug interactions (thiazides and NSAIDs reduce renal lithium clearance). Severe toxicity with neurotoxicity and renal failure is a clear indication for urgent hemodialysis, which rapidly clears lithium from the vascular compartment. Concurrently, isotonic IV saline is infused to restore intravascular volume.

9A 24-year-old woman with bipolar I disorder is being treated by her psychiatrist. She is sexually active and expresses a desire to conceive within the next 1–2 years. Under Swissmedic and European Medicines Agency (EMA) safety guidelines, what is the primary regulatory directive regarding the prescription of Sodium Valproate (Depakine) in female patients of childbearing potential?

A.Sodium valproate is strictly contraindicated in girls and women of childbearing potential unless conditions of a Pregnancy Prevention Program are fulfilled and no suitable alternative exists, due to high risks of congenital malformations (~10%) and neurodevelopmental disorders (30–40%)

B.Sodium valproate is the preferred first-line mood stabilizer for all young women because of its favorable teratogenic profile

C.Sodium valproate may be prescribed freely provided daily folic acid 0.4 mg is co-administered

D.Sodium valproate is only contraindicated during the third trimester due to neonatal hypoglycemia

Explanation: Sodium valproate is a potent teratogen associated with major congenital malformations (neural tube defects, cardiac defects, cleft palate in ~10% of exposed pregnancies) and severe neurodevelopmental deficits (autism spectrum disorders, intellectual impairment in 30–40%). Swissmedic and EMA require a strict Pregnancy Prevention Program (acknowledgment of risk form, highly effective contraception, annual specialist review) and mandate switching to safer alternatives before conception.

10A 31-year-old patient with bipolar II depression is initiated on lamotrigine. The patient is already taking sodium valproate (1000 mg/day) as a mood stabilizer. How does the pharmacokinetic interaction between valproate and lamotrigine affect the dosing strategy for lamotrigine titration?

A.Valproate induces lamotrigine metabolism via CYP3A4, requiring double the standard lamotrigine starting dose (50 mg/day)

B.Valproate significantly inhibits lamotrigine hepatic glucuronidation (UGT1A4), doubling its half-life and requiring at least a 50% reduction in starting dose and titration speed (e.g., 25 mg every other day) to avoid Stevens-Johnson syndrome

C.Valproate has no pharmacokinetic interaction with lamotrigine, so standard titration (25 mg/day) should be maintained

D.Valproate enhances renal excretion of lamotrigine, necessitating immediate therapeutic loading at 200 mg/day

Explanation: Valproate is a potent inhibitor of UDP-glucuronosyltransferase enzymes (specifically UGT1A4 and UGT2B7), which metabolize lamotrigine. Co-administration more than doubles lamotrigine's elimination half-life (from ~25–30 hours to ~60–70 hours). Therefore, the lamotrigine initial dose and titration schedule must be reduced by more than 50% (starting at 25 mg every other day or 12.5 mg/day) to prevent life-threatening severe cutaneous adverse reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

About the Facharzt FMH Psychiatrie und Psychotherapie Exam

The Facharzt FMH für Psychiatrie und Psychotherapie (Specialist in Psychiatry and Psychotherapy FMH) is the Swiss Federal specialist qualification conferring full independent clinical practice rights in adult psychiatry and psychotherapy across Switzerland. Overseen by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and the SGPP/SSPP (Swiss Society of Psychiatry and Psychotherapy), certification requires completing 6 years of postgraduate training (including 4 years of core adult psychiatry, 1 year of somatic internal medicine/neurology, and 1 year of subspecialty/elective rotations) along with an intensive structured psychotherapy curriculum (at least 360 hours of theoretical coursework, 150 hours of supervision, 50 hours of individual self-experience/Selbsterfahrung, and 4 documented long-term therapy cases). Candidates must pass both parts of the official SGPP Facharztprüfung: the written FAP I multiple-choice examination and the FAP II written case thesis and oral colloquium. Note on format and language: While the official SGPP examinations are conducted in Switzerland's national languages (German and French), this question bank represents an English-language multiple-choice study adaptation created by OpenExamPrep—not an official SGPP/SIWF exam release—designed to prepare candidates thoroughly for clinical diagnostic reasoning, evidence-based psychopharmacology, psychotherapy models (CBT, psychodynamic, systemic), psychiatric emergency management, and the Swiss legal framework (Swiss Civil Code ZGB, KESB, and Fürsorgerische Unterbringung FU/FFE Art. 426 ff.).

Assessment

Two-part specialty board examination: 1) FAP I written multiple-choice examination (≥100 MCQs testing general psychopathology, biological/pharmacological psychiatry, psychotherapy theory, and systemic/social psychiatry), and 2) FAP II written case paper (10–20 pages) with an oral case colloquium evaluated by certified SGPP specialist examiners.

Time Limit

180 minutes written FAP I examination plus 60 minutes FAP II oral colloquium

Passing Score

Criterion-referenced standard passing score on the written FAP I examination (typically ~60–65%) and a successful evaluation across all case defense criteria in the FAP II oral colloquium

Exam Fee

FAP I written exam CHF 600; FAP II case thesis and oral colloquium CHF 900; SIWF FMH title application fee CHF 1,000–2,500 (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) and Schweizerische Gesellschaft für Psychiatrie und Psychotherapie (SGPP / SSPP))

Facharzt FMH Psychiatrie und Psychotherapie Exam Content Outline

25%

General Psychopathology, Diagnostic Systems & Affective Disorders

AMDP psychopathological assessment system, ICD-10/ICD-11 and DSM-5 diagnostic criteria, major depressive disorder subtypes (melancholic, psychotic, atypical), bipolar I and II disorders, rapid cycling, cyclothymia, persistent depressive disorder (dysthymia), perinatal mood disorders, and evidence-based acute and maintenance mood stabilization.

15%

Psychotic Disorders & Schizophrenia Spectrum

First-episode psychosis evaluation, schizophrenia symptom dimensions (positive, negative, cognitive), schizoaffective disorder, delusional disorder, acute catatonia (Bush-Francis scale, lorazepam challenge test, ECT), treatment resistance definitions, and long-acting injectable (LAI) strategies.

15%

Anxiety, OCD, Trauma & Stressor-Related Disorders

Panic disorder and agoraphobia, generalized anxiety disorder (GAD), social anxiety disorder, obsessive-compulsive disorder (OCD and high-dose pharmacotherapy), post-traumatic stress disorder (PTSD and trauma-focused modalities), complex PTSD, acute stress disorder, somatic symptom disorders, and functional neurological disorder.

12%

Substance Use Disorders & Addiction Medicine

Alcohol withdrawal management (CIWA-Ar protocol, symptom-triggered benzodiazepines), delirium tremens, Wernicke-Korsakoff encephalopathy (parenteral thiamine protocols), relapse prevention (acamprosate, naltrexone, disulfiram), opioid agonist therapy in Switzerland (OAT: methadone, buprenorphine, diamorphine / HeGeBe), cocaine/stimulant psychosis, and behavioral addictions.

10%

Personality Disorders, ADHD & Neurodevelopmental Disorders

Borderline personality disorder (DBT skills, MBT, crisis and safety planning), antisocial and narcissistic personality disorders, ICD-11 dimensional personality framework, adult ADHD diagnostics (WURS, DIVA) and stimulant pharmacotherapy, autism spectrum disorder in adulthood, and impulsivity management.

10%

Gerontopsychiatry & Neurocognitive Disorders

Etiological differentiation and management of delirium (CAM criteria), Alzheimer's dementia, vascular dementia, Lewy body dementia (antipsychotic hypersensitivity), frontotemporal lobar degeneration, behavioral and psychological symptoms of dementia (BPSD), normal pressure hydrocephalus, and depressive pseudodementia.

15%

Psychopharmacology & Somatic Treatment Modalities

Mechanism of action, receptor binding, and cytochrome P450 pharmacokinetics of antidepressants, second/third-generation antipsychotics, mood stabilizers (lithium monitoring, toxicity thresholds, hemodialysis criteria, valproate teratogenicity), therapeutic drug monitoring (TDM), adverse effect emergencies (extrapyramidal symptoms, akathisia, tardive dyskinesia, NMS vs serotonin syndrome), electroconvulsive therapy (ECT), and repetitive transcranial magnetic stimulation (rTMS).

Psychotherapy Models, AMDP System & Swiss Adult Protection Law (KESB / FU)

Cognitive Behavioral Therapy (CBT: Socratic dialogue, behavioral activation, ERP), Psychodynamic/Psychoanalytic concepts (defense mechanisms, transference, countertransference), Systemic therapy (circular questioning, genograms), Swiss Civil Code (ZGB / CC Art. 426 ff. Fürsorgerische Unterbringung FU / FFE), involuntary medical treatment protocols (Art. 433/434 ZGB), assessment of capacity of discernment (Urteilsfähigkeit Art. 16 ZGB), and adult protection authority (KESB / APEA) measures.

How to Pass the Facharzt FMH Psychiatrie und Psychotherapie Exam

What You Need to Know

Passing score: Criterion-referenced standard passing score on the written FAP I examination (typically ~60–65%) and a successful evaluation across all case defense criteria in the FAP II oral colloquium
Assessment: Two-part specialty board examination: 1) FAP I written multiple-choice examination (≥100 MCQs testing general psychopathology, biological/pharmacological psychiatry, psychotherapy theory, and systemic/social psychiatry), and 2) FAP II written case paper (10–20 pages) with an oral case colloquium evaluated by certified SGPP specialist examiners.
Time limit: 180 minutes written FAP I examination plus 60 minutes FAP II oral colloquium
Exam fee: FAP I written exam CHF 600; FAP II case thesis and oral colloquium CHF 900; SIWF FMH title application fee CHF 1,000–2,500

Keys to Passing

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Facharzt FMH Psychiatrie und Psychotherapie Study Tips from Top Performers

1Master Psychopharmacology Receptor Profiles & Cytochrome Interactions: Understand 5-HT, D2/D3 partial agonism, alpha-1, H1, and muscarinic profiles, alongside clinically vital CYP interactions (such as CYP2D6 inhibition by fluoxetine/paroxetine and CYP1A2 induction by tobacco smoke impacting clozapine and olanzapine levels).

2Memorize High-Yield Safety Protocols & Monitoring: Be fluent in Clozapine ANC monitoring rules (weekly to monthly checks, stopping if ANC < 1.0 x 10^9/L), Lithium therapeutic levels (0.6–0.8 mmol/L maintenance, hemodialysis thresholds), and ECG QTc intervals (>500 ms threshold for intervention).

3Differentiate Emergency Neuropsychiatric Syndromes: Distinguish Neuroleptic Malignant Syndrome (lead-pipe rigidity, hyperthermia, high CK, hyporeflexia, slow onset) from Serotonin Syndrome (hyperreflexia, clonus, ocular clonus, rapid onset) and Catatonia (Bush-Francis scale, lorazepam challenge test).

4Understand Swiss Adult Protection Law Nuances: Know the strict criteria for medical FU (Art. 426 ZGB: Schwächezustand, necessary care cannot be provided otherwise, suitable institution), time limits, appeal rights to a judicial court, and the formal requirements for a written treatment plan and chief physician approval for treatment without consent (Art. 433 ZGB).

5Integrate Evidence-Based Psychotherapy Formulations: Understand core mechanisms of Cognitive Behavioral Therapy (Socratic dialogue, behavioral activation, ERP for OCD), Psychodynamic Therapy (defense mechanisms, transference/countertransference, projective identification), and Systemic Therapy (circular questioning, reframing, genograms).

Frequently Asked Questions

What is the Facharzt FMH für Psychiatrie und Psychotherapie title?

The Facharzt FMH für Psychiatrie und Psychotherapie is the Swiss Federal specialist title granting full independent practice rights in adult psychiatry and psychotherapy across Switzerland. It is awarded by the SIWF / FMH in collaboration with the Swiss Society of Psychiatry and Psychotherapy (SGPP / SSPP) following 6 years of postgraduate training, completion of the formal psychotherapy curriculum, and passing both parts of the SGPP Facharztprüfung.

How is the Swiss Psychiatry and Psychotherapy specialist examination (FAP) structured?

The examination comprises two mandatory parts: 1) FAP I (Teil 1): A written multiple-choice examination consisting of at least 100 MCQs covering general psychopathology, biological/pharmacological foundations, psychotherapy theory, and systemic/social psychiatry. 2) FAP II (Teil 2): A written psychotherapy case study (10–20 pages) followed by an oral colloquium in which the candidate defends the clinical conceptualization, therapeutic process, and theoretical underpinnings before certified SGPP examiners.

When can Swiss psychiatry residents register for FAP I and FAP II?

Residents are typically encouraged to sit FAP I towards the end of their third or fourth year of specialist training once the foundational psychiatric knowledge base is established. FAP II can only be taken after successfully passing FAP I and is recommended during the sixth year of training, when sufficient advanced clinical psychotherapy cases have been completed under supervision.

What are the mandatory psychotherapy curriculum requirements for the FMH title?

Candidates must complete at least 360 hours of structured theoretical psychotherapy seminars (spanning CBT, psychodynamic, or systemic modalities), 150 hours of certified clinical supervision, 50 hours of individual self-experience (Selbsterfahrung) with an accredited therapist, and at least 4 documented psychotherapeutic treatment cases totaling ≥120 therapy hours.

What Swiss legal frameworks are essential for the psychiatry board examination?

Key high-yield legal areas under the Swiss Civil Code (Zivilgesetzbuch - ZGB) include: Fürsorgerische Unterbringung (FU / FFE under Art. 426 ff. ZGB) for involuntary civil commitment; prerequisites and procedures for compulsory medical treatment (Zwangsbehandlung under Art. 433/434 ZGB); assessment of capacity of discernment (Urteilsfähigkeit under Art. 16 ZGB); adult protection curatorship measures (Beistandschaften under Art. 390 ff. ZGB); and advance healthcare directives (Patientenverfügung under Art. 370 ff. ZGB).

Why is this practice bank presented in English?

While the official SGPP examinations in Switzerland are conducted in German or French, modern psychiatric psychopharmacology, neurobiology, and international clinical trial literature are universally published in English. This OpenExamPrep bank adapts the Swiss curriculum, SIWF/SGPP requirements, and Swiss legal standards into 100 comprehensive English-language multiple-choice questions for rigorous study and international clinical benchmarking.

100+ Free Facharzt FMH Psychiatrie und Psychotherapie Practice Questions

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