14th February 2025

A 19-year-old biology student has had disrupted sleep, increased libido and grandiose delusions for the past week.

A 19-year-old biology student has had disrupted sleep, increased libido and grandiose delusions for the past week. She has been unable to attend university due to her disrupted routine. Her GP advises her to go to A&E as she thinks she needs a psychiatric admission.

Observations – RR 17, Sa02 99% on room air, BP 108/78, HR 64, T 36.3

The following blood tests are organised in A&E:

Haemoglobin 131 g/L (130-180)

White Cell Count 6.3 x10⁹/L (3.6-11)

Neutrophils 2.1 x10⁹/L (1.8-7.5)

Platelet Count 199 x10⁹/L (140-400)

CRP 4 mg/L (<5)

TSH 3.1 mU/L² (0.4-4)

Free T4 19 pmol/L (9-24)

Which of the following best describes her episode?

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