After Being Discovered Sitting in the Street Drinking His Own

After being discovered sitting in the street drinking his own urine, a 25-year-old man is taken to the emergency department by ambulance. According to the patient's mother, he voiced concern about being observed by an undisclosed government agency a year ago, and as a result, he broke up with his girlfriend, quit his job, and unplugged his phone. The patient's mother has noted that he no longer appears to be interested in things that used to interest him, and she just discovered that he had relocated into the family garden shed with his dog. The patient is malodorous, unkempt, and laughs for no apparent reason when examined. He grows enraged afterwards and refuses to sit on a chair for the interview. The patient switches among unrelated topics and when asked where he lives says, "in the holy buffet of diplomacy."  Temperature is 36.7 C (98 F) , blood pressure is 122/79 mm Hg, and pulse is 80/min.  Physical examination and laboratory evaluation, including urine toxicology, are unremarkable.  Which of the following is the most likely diagnosis in this patient?

A) Bipolar I disorder
B) Brief psychotic disorder
C) Major depression with psychotic features
D) Psychotic disorder due to a general medical condition
E) Schizoaffective disorder
F) Schizophrenia
G) Schizophreniform disorder

Correct Answer:

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