A 20-Year-Old College Student Is Brought to the Emergency Department

A 20-year-old college student is brought to the emergency department by his roommate.  The patient is frightened and claims that campus police are following him and plotting to kill him.  His roommate says that the patient seemed "totally normal" until a few days ago, when he began to stay up all night to prepare for final exams.  The patient has no known medical or psychiatric history, but his father has schizophrenia.  Blood pressure is 150/95 mm Hg and pulse is 110/min.  Examination shows clear lungs and tachycardia with normal S1 and S2.  The abdomen is soft and nontender.  Extraocular movements are intact, and the pupils are dilated.  The patient is diaphoretic.  He appears hypervigilant, paces during the examination, and has mildly pressured speech.  Which of the following is the most likely diagnosis in this patient?

A) Bipolar disorder, manic episode
B) Brief psychotic disorder
C) Delusional disorder
D) Schizophreniform disorder
E) Substance-induced psychotic disorder

Correct Answer:

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