Patient presents with a primary diagnosis of Schizoaffective Disorder, Depressed Type (F25.1), based on DSM-5 criteria and clinical presentation.  The patient reports persistent depressed mood, meeting criteria for a major depressive episode concurrent with psychotic symptoms.  These psychotic symptoms include auditory hallucinations, specifically derogatory voices, and delusions of persecution, believing they are being monitored by an unknown entity.  These symptoms are present even in the absence of a major mood episode, fulfilling the diagnostic requirement for Schizoaffective Disorder.  Differential diagnoses considered included Major Depressive Disorder with Psychotic Features, Bipolar Disorder with Psychotic Features, and Schizophrenia.  These were ruled out based on the longitudinal course of illness and the presence of psychotic symptoms independent of mood episodes.  Current symptoms significantly impact the patient's functioning in social and occupational domains, resulting in social withdrawal and difficulty maintaining employment.  Treatment plan includes initiation of Risperidone for management of psychotic symptoms and Sertraline to address the depressive component.  Patient education regarding medication management, potential side effects, and the importance of adherence was provided.  Referral to individual psychotherapy and a support group for individuals with Schizoaffective Disorder is recommended to address coping skills, social support, and relapse prevention.  Prognosis guarded, with continued monitoring and treatment adjustments as needed.  ICD-10 code F25.1, Schizoaffective disorder, depressive type, is documented for medical billing and coding purposes.  Follow-up appointment scheduled in two weeks to assess medication efficacy and symptom improvement.