Soru

A 27-year-old man is referred to a psychiatrist for an evaluation requested by his employer. Over the past four years, his coworkers have complained that he behaves oddly, often wearing heavy winter clothing in the middle of summer and muttering to himself in the breakroom. During the interview, the patient makes poor eye contact and displays a constricted affect. He explains that he avoids social gatherings because he feels "out of sync" with others. When discussing his lack of friends, he utilizes fantasy as a defense mechanism, explaining that he does not need physical companions because he maintains strong telepathic connections with others on an "astral plane." He denies ever hearing external voices, seeing things that are not there, or feeling that his thoughts are being controlled by outside forces. His thought processes, while highly eccentric, remain logical. These traits have been stable since his late teens. Which of the following is the most likely diagnosis?