A 30 year old man is brought to psychiatry OPD by his mother. She is very concerned because patient has become increasingly withdrawn and behaved strangely for the last 6 weeks. She reports that he expresses fears that his body is decomposing and hears the voices of his long deceased father telling him, “Come to me.”. Vital signs are normal and physical examination is unremarkable. On mental status examination, the patient appears expressionless and makes poor eye contact. At times, he does not answer and mumbles to himself.

A 35 year old man is brought to psychiatry department by his wife. She says that he has stayed up late every night for the past week, praying and shouting he is “the God’s messenger”. During the evaluation, patient speaks rapidly and believes he has super powers to save humankind. He shakes his head in response to voices, saying that there is fight between good and evil and he will defeat the evil. He has history of psychiatric illness since his early 20s. He has been hospitalized for several depressive episodes over last 10 years. Between hospitalizations, he had periods lasting for several months during which his moods is stable, but he has continued to hear the voices of god.