Question: Mr. Nehru is a single, unemployed 25-year old man who emigrated with his older brother from India to the United States when he was age 13 to live with his Aunt and Uncle. His brother, age 29 years old, brought him to the emergency room after neighbors complained that he was standing in the street harassing people about his religious beliefs. To the psychiatrist he keeps repeating, "I am Vishnu, I am Krishna." Mr. Nehru has been living with his brother and sister-in-law for the past 7 months, attending an outpatient clinic. During the last 4 weeks, his behavior has become increasingly disruptive. He awakens his brother at all hours of the night to discuss religious matters. He often seems to be responding to voices that only he hears. He neither bathes nor changes his clothes during these times. Mr. Nehru's first episode of emotional disturbance was 5 years ago. Medical records are not available, but from his brother's account, it seems to have been similar to the present episode. There have been two other similar episodes during that 5 year span, each requiring hospitalization for a few weeks. Mr. Nehru admits that, starting about 5 years ago and virtually