An 82-Year-Old Man Is Brought to the Office by His

An 82-year-old man is brought to the office by his daughter due to behavioral changes.  She reports that over the past year her father has become increasingly paranoid and frequently talks out loud as if in conversation when no one else is present.  The daughter says, "During a recent argument, he accused me of being an imposter and stealing his personal items.  Also, he used to be very clean, but his personal hygiene has gotten really bad.  He also stopped watching baseball, which used to be his favorite hobby."  The patient's medical history is significant for hypertension, hypercholesterolemia, and type 2 diabetes mellitus.  Medications include lisinopril, simvastatin, and metformin.  The patient has been unable to live independently for the past 2 years due to increasing forgetfulness and an inability to perform self-care.  Vital signs are stable, and physical examination and laboratory evaluation are unremarkable.  Which of the following is the most likely explanation for this patient's behavior?

A) Alzheimer disease
B) Delusional disorder
C) Major depression with psychotic features
D) Schizophrenia
E) Medication-induced psychotic disorder

Correct Answer:

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