MRCP2-3100

MRCP2-3100

A 28-year-old woman presents to her GP with her boyfriend. She reports that over the past few months, her boyfriend has been hearing voices that demand him to do things or simply hum or laugh. He also believes that she is plotting to leave him for his brother and that he has a deadly illness with less than a year to live. These delusions have caused significant strain on their relationship, and he has lost weight, become increasingly nervous, and neglected his appearance. He has no known medical problems, is a smoker of 20 cigarettes per day, and drinks 15 units of alcohol per week. On examination, he appears withdrawn and unkempt, fidgeting with his clothes and commenting on a fishy smell. His mini-mental state examination score is 30/30, and there are no abnormalities on cranial nerve or peripheral nervous system examination or on an MRI scan of his brain. What is the most likely diagnosis for this patient?