This agitated 42-year-old businessman was admitted to the psychiatric service after a 2 1/2-month period in which he found himself becoming increasingly distrustful of others and suspicious of his business associates. He was taking their statements out of context, "twisting" their words, and making inappropriately hostile and accusatory comments; he had, in fact, lost several business deals that had been "virtually sealed." Finally, the patient fired a shotgun into his backyard late one night when he heard noises that convinced him that intruders were about to break into his house and kill him.