A 33-year-old man was taken to the hospital after neighbors reported that he had been singing loudly and playing the piano "nonstop" for the last month. The patient believes his mood is "terrific," that he is related to the President, and that he is destined to be a famous performer. He makes unwanted sexual approaches at several of the female nurses while in the hospital. He has a history of 9 mental hospitalizations for mood and psychotic symptoms beginning at the age of 22. The patient has heard voices remarking on his appearance and believes that covert cameras have been watching him in between hospitalizations, but he has had no mood problems. Which of the following is the most likely diagnosis in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Psychosis must occur in the absence of severe mood episodes for schizoaffective disorder to be diagnosed, but mood episodes must be present during the bulk of this lifelong condition. Psychotic symptoms arise exclusively during mood episodes in bipolar illness and severe depression with psychotic characteristics.

A 33-Year-Old Man Was Taken to the Hospital After Neighbors