Questions:

Mental state examination

Presenting problems

•        22 years old female patient presented to emergency department accompanied by father and sister. Patient is currently a University student studying law.

•       She was poorly groomed, malodorous and appeared with preoccupied, poor attention, hypervigilant and mumbling to surroundings at the time of presentation. Patient has also been noticed with grandiose delusions.

•       Nil history of self-harm or suicide recorded; however, family reports, patient has extensive episodes of delusional and visual hallucinations from last six months.

•      Family reports, patient does not engage much with them and often remains secluded in her room. Patient reports having anger issues and resentment to eat with the rest of the family as she ‘does not feel like getting involved’.

•        Patient has also been suspended from the University due to missing classes along with reports of delusional behavior in the university as patient thinks that her university is a frontier for organized crime operation.

•        Patient is unmarried and has a boyfriend who she visits occasionally and currently has sour and distrusting relationship due to her mental state.

 Past Psychiatric, Medical History and Current Medications

•       Family reports that patient was a good academic student, however from past six months, they have noticed slowness and rejection in mood.

•    Prior to that, patient and family reports nil psychiatric illness. Patient states she had some anger management issue but never ‘took them seriously’.

•       Patient states nil past medical history, however,  had increased headache from past 4 months and visited a GP who diagnosed her with Migraine.

•       Patient has history of # R/arm when she was 8 years old.

•       Patient is currently on PRN Imigran for severe headache prescribed by her GP on 09/07/2020.

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