Snapshot A 47-year old man is brought to the ED by his older brother, who says that the patient has been "acting strangely and not himself" lately. Over the last 8 months, he has claimed to hear voices telling him that "he is the chosen savior of the world." He used to work as a janitor at a local elementary school but was fired recently due to his erratic behavior. On physical exam, he appears unkempt and irritated. He seems to respond to invisible stimuli, and he rambles continuously from topic to topic without a clear focus. Introduction Overview login to view 1 more bullet Epidemiology login to view 9 more bullets Pathophysiology login to view 3 more bullets Associated conditions login to view 8 more bullets Prognosis login to view 5 more bullets Presentation Symptoms login to view 11 more bullets Physical exam login to view 8 more bullets Studies Urine toxicology login to view 1 more bullet Serum labs login to view 4 more bullets Differential Diagnosis Delusional disorder login to view 3 more bullets Schizotypal personality disorder login to view 2 more bullets Schizoid personality disorder login to view 3 more bullets Paranoid personality disorder login to view 3 more bullets Treatment Lifestyle login to view 2 more bullets Medical login to view 13 more bullets Complications Substance use login to view 6 more bullets Suicide login to view 6 more bullets