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OK, so the subject believes it is being attacked by a creature out of its nightmares and makes a full attack against that creature each round, but where does this combat happen? Is it all in the creature's head? It is an Illusion (Phantasm) [Mind-Affecting], but the actual text says: "Each round the subject makes a full-attack action against the creature" not that it imagines it is doing so without actually burning any resources. So, as written, the subject takes real swings in the game world, or does it?
So at what "range" does the imagined combat occur? Is the target locked in melee? It doesn't say so. Does the caster need to specify which square the imagined foe occupies? It doesn't say that either. Would an archer see the creature at range and begin wasting real arrows shooting at it? Does an affected alchemist start lobbing bombs (with Fast Bombs and Rapid Shot that can be quite a few explosives as a full-attack, and with Precise Bombs he doesn't care if the target is only one square over) round after round? With the alchemist example, it makes a huge difference whether the combat is entirely imaginary (and he still has all his bombs when it is over because he only thought he was throwing them) or if he is blowing away bystanders (including the person who cast on him) because they are in the splash zone around his illusory opponent of no fixed position.
This is a case-by-case basis. The "threat" IS all in the creature's head, but they're physically making a full attack action. That's as far as the default rules can take us; the rest is up to the GM...
As for how this effects the rest of the external combat, this is going to depend on what kind combat the creature uses, and this is all how I would handle this; again, this part isn't covered by the rules, though I think the rules expect the GM to handle it in much the same way.
Roll 1d8 (1 is north of the creature, and go clockwise from there). That is where the creature is. If a creature is already occupying this square, that's OK, because the Phantasm doesn't exist. The subject of the spell targets the creature as if it were occupying this square; if another creature occupies it, they get 50% concealment from the subject's attacks, but otherwise are the target. The subject attacks the phantasm to the best of its abilities. If the subject uses Ranged attacks, it takes a 5' step and makes a full-attack action against it. d% may be necessary to determine if other creatures get hit by accident. If the subject uses melee, it makes a full-attack action.
If the subject uses a less conventional attack, such as an Alchemist or d6 HD spellcaster, you have a choice; spells/day and bombs/day are valuable resources, and the players may not be happy about using them up when the spell description pointedly says that they merely make a "full-attack" against the phantsasm. That said, I think it's thematically appropriate to force them to take a 5' step and then throw a bomb or cast an offensive spell. This isn't a full-round set of actions, but it wouldn't make sense for the Wizard to pull out his Dagger for the first time ever and attack something, and you can just make them waste their Move action. Now, depending on the spell cast, or the type of bomb used, many different possibilities can occur, affecting the rest of the combat in different ways, which could make for some very fun and memorable moments. However, if you'd like to play it safe, and stick with the strict RAW, you'd probably be better off having them take out that dagger and full-attacking, or 5'-stepping and using a crossbow, or something. Either way, their actions are physically happening, so if they're being threatened by another creature, drawing a dagger could still provoke, as well as making ranged attacks, etc.
Unfortunately, the spell description doesn't have enough information to have a definitive answer as to what exactly the subject does when it makes a "full attack" against the phantasm, so the GM will have to either waive anything beyond "you waste your turn attacking the phantasm", or expand on what that means.
I think it's clear you make attacks in the real world, the phantasm is layered over your regular perceptions, which is how most phantasms work with the exception of mindscapes.
As a GM, I'd put the phantasm right in your face. You attack it with whatever weapon is in your hand or with your hands. Archers would fire arrows even if they worry about attacks of opportunity. Alchemists...hmm. I wouldn't make one hit himself with splash damage, I guess, but it wouldn't be the end of the world if he did. I'm on the fence.
I actually like the expended resource nature of this. It would make sense from a balancing perspective to make this spell more useful vs its competitors. As written compare it to Hold Person and Hideous Laughter. It falls between them in target/repeat save limitations, but is dead last in combat effectiveness (fatigue after the spell is over is much worse than helplessness or prone during the effect). It's also wiped out by True Seeing (ugh, I hate that) which is more common than enemies that are immune to compulsion but not mind-affecting.
So I'd say that yes, it's actually ok if an alchemist wastes bombs on this, or if a fighter burns his spell storing weapon on it, or a Paladin tries to smite it. But I doubt most GMs would play it that way.
Rezing this thread because a new issue was raised in-game:
Can you use this spell to gain flanking? Since the subject makes a full attack into the space it believes the nightmare opponent occupies, you know where the victim thinks its opponent is. So if you step into the space where the target would be flanked do you gain the bonus because it believes it is flanked?