A Case of a College Student Presenting With Mild Mental Health Problems

A 17-year-old boy was referred from the general practitioner to the local psychosis early-detection clinic owing to a drop in functioning and social withdrawal during the previous 6 months. He began college 6 months prior but had found the workload difficult and failed his examinations. He had no family history of mental disorders, denied any current or past use of drugs, and reported no significant medical history. He was well kempt, was quiet during his interview, and provided short answers. He reported that he no longer enjoyed his former interests and could not relate to people at college or to friends, but there were no clear signs of depressive disorders. No formal thought disorders were elicited. He was 80% convinced that random people looked and talked about him when he was out in public but was able to question it. He stated that these people were probably commenting on the way he looked, but he did not believe these individuals meant him harm. He never acted on these thoughts. He also reported a vague feeling of perplexity and derealization. These experiences began when he started college and continued to occur every day for up to an hour at a time, causing significant distress. The Structured Clinical Interview for DSM did not reveal any mental disorder.