A 17-Year-Old With Hallucinations About Martians and Paranoia

Raheel I. Shaikh; Neal T. Patel; Alexander Martinek; Imran Shaikh, MD

Disclosures

September 28, 2021

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

The parents of a 17-year-old boy explain that he has had hallucinations, delusions, and paranoia for more than 6 months and is acutely excitable. He says he feels as if he is being chased by martians, and he suspects his younger sister of stealing from him.

His medical, social, and psychiatric history is significant for an acute depressive episode 3 years ago. His family history is notable for bipolar disorder in his paternal grandmother. The past medical history of both his parents is unremarkable.

The patient reports no alcohol consumption nor use of hallucinogens. His mother says that he has smoked cigarettes, approximately one pack a week, for the past year. The patient also describes recreational use of marijuana 7 months earlier and says he believes that he smoked about 1 g.

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