30th January 2024

Adam, a 22-year-old male, is brought to the hospital by his family, who have become increasingly concerned about his behaviour

Adam, a 22-year-old male, is brought to the hospital by his family, who have become increasingly concerned about his behaviour. They think that he has become more isolated and ‘odd’ over the last year. He lives alone, but his neighbours report rubbish piling up inside his flat and that sometimes they do not see him for days at a time.

In the consultation, Adam is withdrawn and quiet. His spontaneous movements are reduced, and he makes little eye contact. You struggle to develop a rapport with him, and he frequently wanders off-topic when responding to questions.

He has no past medical history and takes no medications or recreational drugs. Both his father and uncle have had major depressive episodes.

Which of the following features favour a diagnosis of schizophrenia over depression?

Select the SINGLE most appropriate option from the list below. Select ONE option only.