The Editorial Committee of Australasian Psychiatry hopes to engage trainees by providing practice Modified Essay Questions (MEQ) and providing some guidance as to how best to answer these questions. These questions also serve as a good refresher for established clinicians. The practice question appears below and the answers are available via podcast on the journal website. The discussants are Andrew Amos, Lisa Lampe, Louise Newman, George Halasz and Shuichi Suetani. Please note that this MEQ did not go through the extensive vetting process of the Committee For Examinations and therefore may differ in some ways from a typical MEQs.