Review Question - QID 215140

A 25-year-old man is brought to the emergency department after he was arrested for loitering in the parking lot of a local radio station. He says that he was there doing important reconnaissance activity for the FBI because one of the radio hosts was broadcasting secret messages to him. He asks the team to stop talking so that he can communicate his findings telepathically. On presentation, he is wearing a poorly fitting yellow rain jacket with a top hat and mismatched socks. He laughs every few seconds but refuses to say what he is responding to. Collateral is obtained from his mother who says that he was a successful law student with a group of close friends until about 3 months ago when he dropped out and started having his current obsessions. Which of the following is the most likely diagnosis for this patient?