ABSTRACT
CASE 1.1 – Gradual onset of paranoid symptoms A 24-year-old biology graduate is referred to the outpatient department by his general practitioner (GP). He attends with his mother, who has been becoming increasingly concerned about him for some time. He tells you that he is feeling fine in himself. Objectively, you notice that he has reduced spontaneous movements, his tone of voice is monotonous and soft in volume. There is some suggestion that he is defensive or suspicious as he often asks you the reason for your questions and refuses to answer some personal questions. His mood is flat, showing little reactivity during the course of the interview, but he denies feeling depressed. He denies any psychotic symptoms and you are unable to detect any thought disorder.
