![]() ![]() Physical and neurological examinations, as well as special investigations, were normal. His mental state at admission involved mood lability, rapid speech, tangential thoughts and grandiose delusions. He was transferred to our unit for further work-up. He reported déjà vu and gustatory sensations preceding the symptoms but could not recall the episodes. Several weeks after his admission, however, he displayed episodic mutism, posturing and urinary incontinence. He was initially treated in a district hospital for a schizophrenia relapse with mood symptoms secondary to his cannabis use (urine positive for tetrahydrocannabinol). He became non-adherent when visiting family in a rural district. He had previously taken on olanzapine 15 mg daily with flupenthixol depot 20 mg per month but suffered extrapyramidal side effects on risperidone. He functioned well until his first psychotic episode. Developmental and family histories were unremarkable. He previously abused methaqualone and was still using cannabis regularly. ![]() He had no comorbidities or head injuries. He presented with positive symptoms, including auditory hallucinations. Prior to his first admission, social interaction and work performance deteriorated. He had two previous involuntary psychiatric admissions and was diagnosed with schizophrenia. A man in his early 20s presented with aggression, hearing voices and poor sleep for 1 week. ![]()
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