ABSTRACT
This patient, in distress, has come willingly to the clinic seeking help. These are egodystonic symptoms, therefore this scenario tests empathic history taking and mental state examination. This is a common scenario for junior doctors on call: a young adult with his first presentation on an acute psychiatric ward. His mother will be faced with many unknowns and needs patience and reassurance from the doctor. The patient's father will have plenty of questions about future management. It is important to describe in detail all aspects of management. The bio-psycho-social model is a useful framework to use. It is important to emphasise that the medication did help him improve and that he needs to stay on medication to prevent relapse. This is a specialist team dealing with patients who engage poorly with their community mental health teams and have spent long periods in hospitals.
