A saint or ill – difficulties in issuing a medical certificate for a patient with schizotypal disorders and borderline personality
Beata Trędzbor, Ewa Karmińska, Karolina Drzyzga, Jacek Kamiński, Krzysztof Kucia

The authors present a case of a patient who turned to a mental health clinic in order to receive a certificate of mental health. She motivated the request to be a necessary step in the procedure of applying for admission to a religious order. She declared no previous psychiatric treatment and was accompanied by another woman who confirmed the facts stated by the patient. However, the content provided by the patient, the manner of talking, eccentricity in appearance and determination to obtain the certificate called for caution in issuing such an opinion. The patient agreed to proposed hospitalisation for observation of her mental health. During her stay on the ward, the patient was interviewed and the information collected was cross-referenced with information obtained from the patient’s parents and from previous hospitalisation reports. Psychological tests and CT scans were carried out. The obtained data and observation of the patient on the ward indicated both the presence of a mental illness and deep deficits in personality. This case confirms the need for exercising prudence in issuing opinions on mental health. It highlights the fact that one-sided objective interview may not reveal the real picture of the patient’s mental health.