Scenario A:

A 72-year-old man who has come to see you for low mood. On review, he also tells you that he has not been sleeping properly, and he also thinks he has lost some weight. These symptoms have been going on for about four to five weeks. He denies any delusions, hallucinations or history of mania. He has not had any trouble with his memory, but you test it anyway, and find it is in the normal range. A physical examination and basic blood tests are normal.

Scenario B:

A 20 years-old man who is brought to your clinic by his friends. They are very worried about him because he is afraid that the government are monitoring him, and keeps saying that he can hear people talking about him. When you ask them for more information, they say that he has not been himself for several months, at times does not make sense, and has not been coming to university much. He is about to fail the semester. There is nothing remarkable on physical history, examination or blood tests, and his urine drug screen is negative. When you speak to him, he seems suspicious of you, does not make a lot of sense, and does not think that there is anything wrong with him. He wants to leave, and starts to become quite aggressive when you ask him to stay, saying that he is unsafe here and people are watching him.

to him, he seems suspicious of you, does not make a lot of sense, and does not think that there is anything wrong with him. He wants to leave, and starts to become quite aggressive when you ask him to stay, saying that he is unsafe here and people are watching him.

Scenario C:

A 57 years-old man who is brought in by his family after having a period of shaking, rigidity and incontinence at home. He is currently confused and drowsy and does not know where he is. He reports he has always been happy and healthy, did well at work. He is worried that he has been possessed by a spirit. When you speak to him, he is still not sure what has happened and why he is in hospital. he complains of weakness down one side of his body and feeling sore all over.

Scenario D:

A 69-year-old woman who comes to see you with her daughter. she is worried that her mother is not well. She reports that her mother seems to forget and lose things. Once she came home from work and she was not there, and she found her wandering around the neighbourhood looking lost. She used to always dress immaculately, but lately is not looking after herself as much. When you ask her, she tells you there is nothing wrong, she is fine and certainly “not depressed or mad”. You test her memory, and she does not know the current date, or the dates of her daughter’s birthdays.

Scenario E:

A 51-year-old man whom you normally treat for TB. You have noticed on several occasions over the past two years that he seems to smell of alcohol and is unsteady on his feet. You know that he has not been able to keep a job for a long time, even though he would like to still be working, and his wife left him one month ago. At the time, you assessed him for depression or dementia but you did not think he had either of those, and his mental state has not changed since that review. On today’s review, you examine him for complications for TB, and notice he has signs of relapse, including fever and coughing.