(Sam)

1. Analysis of symptoms development

2. Analysis of possible risk factors of the presenting patients

3. Analysis of the etiology of disorder development based on biological psychocological and social theroies

Sam:

Sam is a 25-year-old African American who is incarcerated for robbing a jewelry store. He reported that he was "framed" for this offense. Sam reported that he was engaged in a "spiritual battle" against demonic spirits who told him to shoot himself. During the interview, he stated that he had "telepathic skills," meaning that he heard voices inside his head with whom he had conversations. He felt disappointed he was unable to complete his suicide and asked the staff to call the FBI but declined to explain the reason for his request. The voices gave him "hypnotic commands" and also had the power to "increase his own serotonin." He did not believe that the voices were part of any illness but just telepathic communications with demonic beings. He reported how voices controlled him: "They enjoyed controlling me. They keep me from having complete thoughts. I find myself not realizing what I am trying to do; they make me feel "gyroscopic," having heartburn, and they have the ability to nullify my medications." The patient indicated that he had difficulties maintaining his train of thought: "Voices keep me from having complete thoughts very often, and they block my thoughts, keep me from doing things, and get me scared." The voices were in total control of his future, and suicide was his only option: "I am not able to control my future enough to make things not happen." Sam first consulted a psychiatrist when he was 17 and reported paranoid thinking. He started to hear voices at 21.