Diagnostic Narrative in the DSM-IV Casebook

On admission to the psychiatric hospital, Louise sat with her hands tightly clasped in her lap and avoided looking at the doctor who interviewed her. She answered questions readily and did not appear suspicious or guarded, but her affect was shallow. She denied depressed mood, delusions, or hallucinations. However, her answers became increasingly idiosyncratic and irrelevant as the interview progressed. In response to a question about her strange cooking habits, she replied that she did not wish to discuss recent events in Russia. When discussing her decline in functioning, she said, 'There's more of a take-o mechanism when you're younger.' Asked about ideas of reference, she said, 'I doubt it's true, but if one knows the writers involved, it could be an element that would be directed in a comical way.' Her answers were interspersed with the mantra, 'I'm safe. I'm safe.'