Formulation: biopsychosocial and 4Ps

Meet the patient

A 19-year-old apprentice is admitted with six weeks of persecutory delusions, auditory hallucinations, and functional collapse. He smokes high-potency cannabis daily, slept four hours a night through his exams, and his older sister — the only person he still talks to — says he has been "different" since he was fourteen.^[6]

Two registrars write two notes. The first says "schizophrenia, start antipsychotic." The second says the same diagnosis, then explains why this person, why now, what keeps it going, what protects him, and what we do first — and links every intervention to a factor. The examiner, and the patient, only remember the second note.^[6][7]

References18ShowHide

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