Gregory Baker is a 20-year-old African American man who was brought to the ER by the campus police. He had been suspended several months earlier from his university. A professor called the police when Mr. Baker entered a classroom shouting, "I am the Joker, and I am looking for Batman." He refused to leave, prompting security intervention. Despite academic success as a teenager, Mr. Baker's behavior had become increasingly odd over the past year. He stopped seeing friends and spent most of his time lying in bed staring at the ceiling. He lived with several family members but rarely interacted with them and was suspended from college due to lack of attendance.

His sister noted recurrently observing him mumbling to himself. At night, he would stand on the roof, waving his arms as if conducting a symphony. He denied suicidal thoughts but claimed he felt liberated by the music. Despite encouragement from his family, he never saw a psychiatrist and had no prior hospitalizations.

In recent months, Mr. Baker became preoccupied with a female friend, Anne, who lived nearby. He insisted to his family that they were engaged, though Anne told his sister they were not dating. Mr. Baker wrote many letters to Anne but never mailed them; they accumulated on his desk. His family reported no use of illicit substances or alcohol, and his toxicology screen was negative. He became angry when asked about drug use and did not respond.

In the ER, Mr. Baker was well-groomed but generally uncooperative. He was constricted, guarded, inattentive, and preoccupied. He became enraged when the ER staff brought him dinner, insisting all hospital food was poisoned, and only wanted a specific type of bottled water. He exhibited paranoid, grandiose, and romantic delusions but denied hallucinations. Mr. Baker reported feeling "bad" but denied depression and had no disturbance in sleep or appetite. He was oriented and articulate but refused formal cognitive testing. His insight and judgment were poor.

Family history includes a grandmother who died in a state psychiatric hospital after 30 years, diagnosis unknown. Mr. Baker’s mother, reportedly "crazy," abandoned the family when he was young. He was raised by his father and paternal grandmother. Ultimately, Mr. Baker agreed to sign himself into the psychiatric unit, believing Anne would be there.

**For the case study described below, create a multi-axial diagnosis. List what you would diagnose for each of the 5 axes and briefly explain your reasoning for each selection:**

**AXIS I: _________________________________**

- Explain your reason for this specific choice by listing and discussing the criteria for the disorder you selected, as well as symptoms or details from the case that exemplified this criteria and disorder.

**AXIS II: _________________________________**

- Explain your reason for this specific choice by listing and discussing the criteria for the disorder you selected, as well as symptoms or details from the case that exemplified this criteria and disorder.

**AXIS III: _________________________________**

- Explain your reason for this specific choice by listing details from the case that are clear medical issues (avoid diagnosing medical issues; stick to details within the case).

**AXIS IV: _________________________________**

- Explain your reason for this specific choice (Note: Consider the past 6-12 months).

**AXIS V: _________________________________**

- Explain your reason for this specific choice by briefly describing why you selected the particular GAF score, discussing indicators of severity or lack thereof.