History A 30-year-old shop assistant presents to the emergency department requesting that they remove the microchip from her brain. She says that this chip was implanted into her brain some weeks ago in order that aliens could control her mind. She has previously been diagnosed with paranoid schizophrenia and has had a number of previous admissions to psychiatric hospitals. She has been previously treated with different psychotic medications and is currently taking olanzapine 20 mg once daily.
There is no family history of mental illness. Mental state examination She presents as unkempt and is surprised that she is being asked about her previous psychiatric history rather than being referred to a neurosurgeon for removal of the microchip. Despite this it is possible to establish a good rapport. At several points during the interview she stops speaking in mid-sentence and stares intently…
