History A 79-year-old man presents with his family. They are concerned that his behavior has become more unpredictable. He has also started to become more and more suspicious of all his family members, particularly his wife. He thinks she is poisoning him and will now no longer eat anything she has cooked. He does not even trust her to make him a drink. He has become more hostile and aggressive.
His sleep is disturbed and his appetite has increased with some weight gain. He has no past psychiatric history. He has a complex medical history and he has most recently been treated for pulmonary fibrosis which had been relatively stable. However, following a bout of pneumonia, his breathing was compromised so a new regime of medication was started. He is on 5 mg prednisolone three times daily and has been taking this for 6 weeks. The family report he had a course of steroids previously but…
