Chief Complaint:

“You all are all morons! I want to go home. There’s nothing wrong with me and I shouldn’t be here. Do you see that there are alien doctors at the hospital, and they are helping to take over if we don’t do something to stop them?”

History of Present Illness:

37-year-old female brought into the state psychiatric hospital by the police. The patient attacked a police officer under the bridge where she is apparently living. The police were investigating a report of theft of food from a nearby grocery store. The report included information about the thief did not appear to be making any sense talking about needing food to store for when aliens invade the planet. The police report that when they went to investigate the reported theft, the patient talked of the city water supply being poisoned by aliens, seeing aliens under the bridge that look just like her and that alien men had been raping her.

PMH:

Depression 5 years ago secondary to the death of her son; reports being on anti-depressants for a few months; denies history of any other mental health concerns

Complications secondary to arthroscopic knee surgery resulting in long term IV Vancomycin

Lymphoma diagnosed 7 years ago treated with six cycles of chemo with excellent response, in remission

+PPD for six years, treated for 12 months

Family Hx:

Mother diagnosed with schizophrenia at age 36

Maternal grandfather – placed in an ‘insane asylum for hysteria’

Social Hx:

Divorced with a daughter, son is deceased

Heterosexual

Homeless – living under the bridge, stating her family disowned her ‘years ago’

Employment history – primary work experience as a nurse aid, reports she has ‘difficulty keeping a job’