Mr D. was working on a reality television show when he was hospitalised after causing a public disturbance. While working on the production of the show, he came to believe that he was the one who was actually being broadcast: ‘‘I thought I was a secret contestant on a reality show. I thought I was being filmed. I was convinced I was a contestant and later the TV show would reveal me.’’ He believed his thoughts were being controlled by a film crew paid for by his family. During the 2 weeks prior to admission, he experienced decreased sleep, pressured speech, irritability, paranoia, and hyperreligiosity. The patient carried a diagnosis of bipolar disorder and had had two previous hospitalisations for manic episodes.