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Assignment:
Ms. Neighbors is a 25 year old, single, unemployed African American woman who was evaluated in the crisis center after her sister observed that her behavior had become increasingly bizarre and her work habits erratic. She had no prior psychiatric history.
Ms. Neighbors lost her job 3 months ago and had become increasingly preoccupied with her neighbors who she felt were harassing her by "accessing" her thoughts and then repeating them to her. She admitted to feeling "stressed" since she lost her job.
She presented as poised, attractive and appeared perfectly normal which surprised her evaluators after they had read her admission complaints. She had no insight as to why she was being evaluated. She denied mood disturbance and denied having any psychotic symptoms. When asked if anyone could read her mind, she replied, "Yes, it happens all the time," and described how when she was planning her dinner in silence, she heard her neighbors reciting her menu out on the street. She claimed that everyone developed telepathic powers in childhood and she had just become aware of hers. She was also upset that her neighbors were critical of her and saying that "You're no good" and "You have to leave." She admitted to thinking about having a "contract" put out to "eliminate" the neighbors.
The patient was medicated and her beliefs about thought broadcasting remitted. Within 2 months she was employed and feeling well.
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