Question:
A person attacks his co-worker, complaining that the co-worker has been plotting to harm him. He hears voices. On examination, the person is found to have disorganized speech. What is the next step in this case?
A person attacks his co-worker, complaining that the co-worker has been plotting to harm him. He hears voices. On examination, the person is found to have disorganized speech. What is the next step in this case?
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Violent act with delusions, hallucinations, and disorganized speech requires psychiatric assessment and fitness-for-trial evaluation.
Updated On: May 14, 2026
- Refer for anger management
- Refer for psychiatric assessment and check if he is fit for trial
- He is not responsible because he is mentally ill
- Start immediate trials and punishment
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The Correct Option is B
Solution and Explanation
Concept:
When a person commits a violent act and has symptoms of psychosis such as delusions, hallucinations, and disorganized speech, psychiatric assessment is necessary. Legal responsibility and fitness for trial should be assessed by appropriate mental health professionals.
Step 1: Identify psychotic symptoms.
The patient believes that his co-worker is plotting to harm him. This suggests a persecutory delusion.
Step 2: Identify hallucination and thought disorder.
He hears voices and has disorganized speech. These features strongly suggest psychosis.
Step 3: Choose the next step.
Since there is violence with possible psychosis, the next step is not direct punishment or simple anger management. The patient should be referred for psychiatric assessment and evaluation of fitness for trial. Therefore, the correct answer is Refer for psychiatric assessment and check if he is fit for trial.
Step 1: Identify psychotic symptoms.
The patient believes that his co-worker is plotting to harm him. This suggests a persecutory delusion.
Step 2: Identify hallucination and thought disorder.
He hears voices and has disorganized speech. These features strongly suggest psychosis.
Step 3: Choose the next step.
Since there is violence with possible psychosis, the next step is not direct punishment or simple anger management. The patient should be referred for psychiatric assessment and evaluation of fitness for trial. Therefore, the correct answer is Refer for psychiatric assessment and check if he is fit for trial.
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