Case 1 – The Fearful Patient

You are about to see Mr. Oberman, a 23 year old male, in your outpatient clinic. He is a long time patient of yours. He comes to your office today because he’s becoming increasingly afraid to leave his house and he wants your help. He is very agitated. Please take a focused history of his complaint.


  • Asks patient about content of fears (feels he’s being persecuted)
  • Asks why he believes he’s persecuted
  • Onset of beliefs
  • How beliefs have changed his life, and what he has done about them
  • Other delusions (denies delusions of grandeur, somatic, parasitosis, etc.)
  • Visual hallucinations
  • Auditory hallucinations
  • Tactile hallucinations
  • Ideas of reference
  • Asks if patient has been harmed by anyone, or has harmed anyone
  • Homicidal ideation
  • Suicidal ideation
  • Symptoms of depression
  • Symptoms of mania
  • Symptoms of anxiety
  • Alcohol and Smoking history (quantity in pack-years)
  • Other drug use, especially marijuana and hallucinogens
  • Current medications and Allergies
  • Occupational history
  • Legal history
  • Current social supports
  • Family history of schizophrenia
  • Family history of other psychiatric illnesses
Case 1 – The Fearful Patient