A 52-yeаr-оld mаn with histоry оf hypertension, hyperlipidemiа, and type 2 diabetes mellitus is admitted to the hospital for treatment of cellulitis after presenting to the emergency department with two weeks of progressive redness, swelling, and pain in his right upper extremity. During the admission process, the patient’s brother pulls the admitting physician aside and tells her that over the past year, the patient has been getting “more out there in his beliefs,” and the decision is made to consult psychiatry. During psychiatric evaluation, the patient says that he has been “working for the CIA,” and he receives messages about his assignments “directly through the TV and radio in coded messages.” What is the best description of this reported experience?