ABSTRACT
This chapter presents a case of a 17-year-old man who attends the accident and emergency department with his girlfriend. He lives with his parents, who do not know he is here. She says that for the last 4 weeks he has been seeing things that scare him in the night. He often cannot describe them but they are large shapes that move and are accompanied with strong sensations of fear. Dopamine-blocking antipsychotic medication such as olanzapine, risperidone or quetiapine may be used if symptoms do not abate. Treatment includes close monitoring and is likely to require admission to hospital. If the patient poses a risk to himself or others, use of the Mental Health Act and hospital admission should be considered. The care plan should include consideration of the patient's family and his social needs. Support will be needed to help him regain his confidence and a relapse prevention plan will need to be drawn up once recovery is underway.
