15th February 2025

A 65-year-old patient is readmitted to the adult male psychiatric ward following a recent discharge.

A 65-year-old patient is readmitted to the adult male psychiatric ward following a recent discharge. He remains preoccupied with the idea that he is being targeted by gangs from an opposing football team, and the crisis team were concerned for his safety due to self-neglect. On further questioning, he says that he has occasionally seen these gang members from his window: they were different strangers each time. This has been fully investigated by the police over the last year, and no evidence has been found. His affect, speech and behaviour remain unaffected, other than when he becomes agitated talking about the gangs he believes are targeting him. He is not experiencing any hallucinations, negative symptoms, or experiences of influence, passivity or control. There is no evidence of formal thought disorder. Although you would want further history, what is the most likely diagnosis?

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