Article Text

Download PDFPDF
Diagnostic conundrum: lessons from the man who accidently set fire to his home
  1. Sahan Benedict Mendis1,2,
  2. Victoria Lukats1
  1. 1Department of Brunswick Ward, Sussex Partnership NHS Foundation Trust, Hove, UK
  2. 2Brighton and Sussex Medical School, Trafford Centre, Brighton, UK
  1. Correspondence to Dr Sahan Benedict Mendis, s.mendis82{at}


A 62-year-old man presented to psychiatric services with a 3-month history of a range of symptoms which included obsessional thoughts, self-neglect, lack of mental flexibility, reduced ability to plan, organise and follow instructions, reduced capacity to empathise and disinhibition. He also accidently set fire to his house. Overall these findings are compatible with a dysexecutive syndrome. This man has a significant history of polysubstance misuse and chronic hepatitis C infection. Neuroimaging revealed an acquired traumatic brain injury which could account for his dysexecutive syndrome. The patient was managed in a holistic manner. A community psychiatric nurse was allocated, he had social services input and he was started on trazodone. He is currently housed in short-term housing and is awaiting a long-term residential placement.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors SBM substantially produced this original case report as he is the primary author. VL is the secondary author and was involved in reviewing the content and making editorial amendments to the original case report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.