ABSTRACT
In this case, the psychiatrist originally suspected a paranoid psychosis due to the patient's extreme reluctance to divulge information about herself and her family. Given the difficulty in communication and the potential severity of her symptoms, it would have been tempting to start the patient on antipsychotic medication. Fortunately, the reason for the guarded, seemingly paranoid behavior became clear after more information was obtained. In this case, it would be useful to obtain more information from the family and other refugees to determine a baseline of commonly accepted ideas, and thus tease out reality from any delusional material.
