The patient was a 51-year-old white French man who met the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) criteria for resistant schizoaffective disorder (bipolar type with continuous following course). He presented with agitation and expensive mood with mood-congruent delusions (persecution, megalomania, and mystical experiences). These symptoms were associated with auditory hallucinations and disorganized speech. Initial diagnosis was established in 1982. Owing to the severity of his disorder, he had been an inpatient since 2001.
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