Theravada Buddhist monks living at a temple bring a 27- year-old Laotian man to the hospital. The man apparently has fasted for 17 days. The man is acutely dehydrated and emaciated. The pt is admitted to the medicine service. He is delirious at first, but when he improves, the psychiatric consult service is called b/c of his "odd manner". The pt is unkempt and unshaven, which is in sharp contrast to the two other members of his order. The pt does not speak English and one of the monks translates to help the psychiatrist with the evaluation. The pt appears withdrawn and responds very briefly to the other monks, at times laughing inappropriately. The monks say that the man's family, who had recently emigrated from Laos, brought him to the order nearly 1 year ago. Although he has been withdrawn since they have known him, the monks say that this is the first time he has embarked on such a fast. He told them that he was instructed to do so by "spirits", who watch his daily activities and comment on whether he is being appropriately observant. The members of his order are familiar with the names of the spirits from Lao folk traditions, but they are not familiar with this particular tradition of fasting. They acknowledge that the man is from a remote part of Laos, of which the are unfamiliar with the customs. What is the likely diagnosis?
A. Culturally appropriate behavior.
B. Major depressive disorder.
C. Psychotic disorder due to another medical condition.
D. Schizophrenia.