Reference no: EM133310388

Case Study: Jim was a 20-year-old African American man who was brought to the emergency room (ER) by the campus police of the university from which he had been suspended several months earlier. The police had been called by a professor who reported that Jim had walked into his classroom shouting "I am the Joker, and I am looking for Batman." When Jim refused to leave the class, the professor contacted security. Although Jim had much academic success as a teenager, his behavior had become increasingly odd during the past year. He quit seeing his friends and spent most of this time lying in bed staring at the ceiling. He lived with several family members but rarely with any of them. He had been suspended from college because of a lack of attendance. His sister said that she had recurrently seen him mumbling quietly to himself and noted that he would sometimes, at night, stand on the roof of their home and wave his arms as if he were "conducting a symphony." He denied having any intention of jumping from the roof or having any thoughts of self-harm but claimed that he felt liberated and in time with the music when he was on the roof. Although his father and sister had to encourage him to see someone at the university's student health office, Jim had never seen a psychiatrist and had no prior hospitalizations. During the prior several months, Jim had become increasingly preoccupied with a female friend, Ann, who lived down the street. While he insisted to his family that they were engaged, Ann told Jim's sister that they had hardly ever spoken and certainly were not dating. Jim's sister also reported that he had written many letters to Ann but never mailed them, instead, they just accumulated on his desk. His family said that they had never known him to use illicit substances or alcohol, and his toxicology screen was negative. When asked about drug use, Jim appeared angry and did not answer. On examination in the ER, Jim was a well-groomed young man who was generally uncooperative. He appeared constricted, guarded, inattentive, and preoccupied. He became enraged when the ER staff brought him dinner. He loudly insisted that all of the hospital's food was poisoned and that he would only drink a specific type of bottled water. He was noted to have paranoid, grandiose, and romantic delusions. He appeared to be internally preoccupied, although he denied hallucinations. Jim reported feeling "bad" but denied depression and had no disturbance in his sleep or appetite. He was oriented and spoke articulately but refused formal cognitive testing. His insight and judgment were deemed to be poor. Jim's grandmother had died in a state psychiatric hospital, where she had lived for 30 years. Her diagnosis was unknown. Jim's mother was reportedly "crazy." She had abandoned the family when Jim was young, and he was raised by his father and paternal grandmother. Ultimately, Jim agreed to sign himself into the psychiatric unit, stating, "I don't mind staying here. Ann will probably be there, so I can spend my time with her."

Question: Post your diagnosis line with DSM -5tr and reasons.