Case practice · Forensic
fo-02 · AdvancedRhys: "I remember nothing"
The case (fictional)
Rhys is 39 and lives in Cardiff. He is charged with causing serious injury to another man in a fight outside a pub. He says he remembers nothing from leaving the pub to waking in a police cell. His solicitor asks a psychologist to assess his memory and mental state.
He says he drank "about ten pints" that evening. CCTV shows him walking steadily and arguing coherently with the other man before the fight. Two years ago he was knocked out briefly in a rugby match. He says that since then his memory has been "shot": he forgets his bank PIN and gets lost driving to familiar places. His partner, though, says he manages the household bills and coaches a junior rugby team every Saturday.
On a brief memory screen done in custody he scored lower than many people with moderate dementia would, and he got wrong several items that almost anyone can answer. His GP prescribed sertraline six months ago for low mood.
He says, "I would never hurt anyone. That is not me." He is on bail and faces a possible prison sentence if convicted.
Identify differential diagnoses and what you would assess next
Identify the possible explanations for Rhys's claimed amnesia and memory problems, and say what you would assess next.