MRCP2-2175

MRCP2-2175

A 25-year-old man presents to you with symptoms of severe depression. He reports feeling anhedonic and has experienced a loss of appetite over the past 6 months. Prior to this, he was a high-achieving individual with a large social circle. He has no known medical conditions, but his father has a history of bipolar disorder. He denies any substance use.
During the examination, he avoids eye contact and appears expressionless. He reports experiencing second-person auditory hallucinations for the past 4 months. His handwriting is small and cramped, and he has a slow gait with increased tone in his left arm.
Laboratory investigations reveal the following results:

Albumin 40 g/l 35–55 g/l
Alanine aminotransferase (ALT) 25 IU/l 5–30 IU/l
Alkaline phosphatase (ALP) 90 IU/l 30–130 IU/l
Bilirubin 15 μmol/l 2–17 µmol/l
What is the most likely diagnosis?