Tim, a 32-year-old male was brought to an emergency room by police, after neighbors were concerned about his behavior, and who indicated that he was "schizophrenic." The police officer that took him to the hospital stated that Tim was referring to himself as the "lord and savior of the world." At the hospital, he was difficult to restrain and was given medication to reduce agitation. He was then put into restraints. Although he was restrained and given medication he was noted by the ER team to be laughing and agitated, still stating that he was receiving special messages from the "lord." He indicated that he no longer needs to sleep because he has "evolved past that." He displayed very fast speech that was hard to understand, as it appeared incoherent. Per the electronic medical record, he had been in the hospital a few times over the past couple of years under very similar circumstances. After these hospitalizations, he was referred to a mental health outpatient program but he never attended any sessions. He received a blood draw to test whether he had ingested any substances, which all came back negative. Upon mental status examination, he was observed to be poorly groomed, inattentive, and with poor eye contact. He was verbose and spoke loudly, despite being asked to speak quieter. He was significantly restless laying in the hospital bed. His thought content was notable for delusions of grandiosity, though overall he thinking was disorganized. He denied hallucinations or suicidality. When asked about what time of the day it is, he answered by giving his view of time as a theoretical construct.

Tim's mother provided collateral information, noting that he had been acting rather odd a few days earlier. Specifically, he was arguing with anyone and everyone at a cookout, and telling them about his special talents. Tim's mother stated that there is a family history of "severe mental illness" but was unsure about what they have, stating "I'm not the expert, I thought you guys were!" She noted a history of some marijuana and alcohol use over the past 10 years but was unsure about any other details. She added that he is a paralegal and has an associate's degree.

• Evaluate the diagnosis, etiology, and treatment plan presented by the group, then indicate your support or rejection using evidence from this module. Specifically, state evidence supporting or contradicting the group's diagnosis, etiology, and treatment plan.
• What other diagnoses would you consider?
• What other etiological factors would you consider?
• What other treatments are available for the diagnosis?