ABSTRACT
Angela Reilly is a 45-year-old bank clerk. She has been in trouble at work because she has been persistently late despite living only three miles from her bank. Her boss has told her that she is ‘slow’. There have been no complaints about the quality of her work. Slowness can be a symptom of different psychopathologies. Depression with psychomotor retardation and obsessive-compulsive disorder with rituals need to be investigated. Her age of presentation and her reasonably high level of functioning make a psychotic illness or cognitive impairment unlikely. Physical illness or substance misuse is not suspected. If a life-threatening, traumatic event can be identified in the history then post-traumatic stress disorder symptoms need to be investigated. These symptoms are often triggered by sights, sounds and smells associated with the trauma. The patient feels like he cannot escape the memory of the traumatic event, particularly when he is having a flashback.
