Is the pen lifted from one afflicted with paranoid personality disorder, severe depression, and psychotic symptoms to the extent of reclusiveness and lack of perception? Does the ruling on the insane apply to him? And does Allah accept his prayers, supplications, and good deeds?

Measuring the mental capacities of a mentally ill patient falls to specialized psychiatrists, not to a Mufti, because depression and introversion vary in degrees and types. Determining the patient's eligibility and their religious and legal responsibility, especially for the "ma'tuh" (mentally deficient person) whose condition is ambiguous, fluctuating between rationality and its absence, requires presenting their case to a doctor or a committee of doctors for assessment and the writing of a medical report.

Al-Sam'ani, Al-Bukhari Al-Namla, and Ibn Baz all defined the "ma'tuh" as a type of insanity or an affliction that causes a defect in the mind, differing from a madman in that he possesses a weak mind and may be able to distinguish. Accordingly, the ma'tuh is not held religiously accountable, analogous to the madman and the undiscriminating child, due to the weakness of his mind in comprehending matters and understanding religious discourse.

If a person afflicted with a personality disorder is diagnosed as lacking the ability to perceive and distinguish matters, then the pen has been lifted from him until he recovers; based on the saying of the Prophet (peace and blessings be upon him): "The pen has been lifted from three: from the sleeper until he wakes up, from the child until he reaches puberty, and from the madman until he regains his sanity." Medical examination is best suited to determine this.