The patient's "bizarre" behavior has been occurring for the past year. He has only been treated for hypothyroidism with levothyroxine for 6 months. Since the bizarre behavior he was brought in about today predates him even starting on levothyroxine, the diagnosis is Schizophrenia (Hallucinations, >6 months).
I fell for the trap and went down the road of thinking his thyroid was being overrated, causing hyperthyroid induced psychosis, but after reading that the behavior predated it, it made it not the correct answer.
Can anyone help explain to me why he has lower extremity hyperreflexia and upper extremity resting tremor? I can't find anything that associates those symptoms to Schizophrenia.