Chronic fatigue syndrome associated with a psychotic state resulting in multiple
murders.
M. Ghahramani and V. Gooriah,
Bull. Amer. Acad. Psychiatry & the Law
23(4): 613-6, 1995.
A 28-year-old, ambitious, academically successful Asian man with a zeal for hard work develops
infectious mononucleosis and its resultant lethargy and fatigue. He becomes depressed, then
develops symptoms of mania before turning floridly psychotic. In his psychotic state he develops
grandiose delusions about being the second son of God after Christ and takes it upon himself to rid
the world of all evil by defeating the anti-Christ. He kills four people and seriously injures a fifth.
He is arrested and found not guilty by reason of insanity. He remains a diagnostic puzzle for a long
time before starting to respond to neuroleptic medication.