ABSTRACT
David Peacock agrees to see people in outpatients because he fears what he might do to his wife. He punched his wife in the face recently, claiming that he had heard voices stating she is regularly unfaithful. They have been married for over 15 years and this problem has been present for the last month. He is 45 years old. It is important to explore the phenomenology; whether this belief of infidelity is a delusion, a preoccupation or an obsession. This belief may be heightened by alcohol intoxication. The next stage is to elicit the existence of other associated beliefs and to see how these beliefs are connected. There may be ‘knight’s move thinking’ among beliefs, suggestive of a psychotic process. A background history, exploring risk factors, is also important. Especially his previous relationship history, forensic history and whether there is any evidence of a paranoid, borderline, dissocial or dependent personality disorder.
