A 17-year-old student is brought to the ED by his parents. In the last year examination, his grades have suddenly dropped, he is irritable with friends and family, he has no energy, he doesn’t go to bed until 1 AM, and he has a poor appetite.

He also has auditory hallucinations in which a man’s voice tells him that he is a “lazy bastard” and that his family “would be better off with him dead.”