Case Lab · Type F · Boundary

F25

Sorting the evidence — psychosis and mania, weighed together

Layla, 33, has a six-week history of hearing two voices discussing her every move and a fixed belief that she has been chosen to deliver an important message to world leaders. During the same six weeks, she has slept only two to three hours a night without feeling tired, talked rapidly and often changed topics mid-sentence, spent significantly more money than usual, and describes feeling she has unique abilities to fix global problems. Her family says this exact combination — voices, the special-mission belief, and this energetic, sleepless state — has happened once before, two years ago, and resolved together after treatment.

For each statement, choose the reasoning role it plays.

0 of 6 evidence statements classified

Two voices discussing her every move, and a fixed belief about a special mission. Missing and necessary to ask Contradicts or weakens Supports the target category Raises an alternative Consistent, but not decisive

Reduced need for sleep, pressured speech, impulsive spending, and grandiosity, all in the same six-week period. Missing and necessary to ask Consistent, but not decisive Raises an alternative Contradicts or weakens Supports the target category

The grandiose belief content (a special mission to world leaders) fits with the elated, grandiose mood. Supports the target category Contradicts or weakens Missing and necessary to ask Raises an alternative Consistent, but not decisive

This same combined pattern occurred once before, two years ago, and resolved together. Raises an alternative Missing and necessary to ask Contradicts or weakens Supports the target category Consistent, but not decisive

Whether any substance use coincided with either episode. Raises an alternative Consistent, but not decisive Missing and necessary to ask Supports the target category Contradicts or weakens

Layla is 33 years old. Supports the target category Contradicts or weakens Consistent, but not decisive Missing and necessary to ask Raises an alternative