What DSM diagnosis would be appropriate for John?

John's symptoms suggest that he may meet the diagnostic criteria for Schizoaffective Disorder, Bipolar Type, according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).

Schizoaffective disorder is characterized by a combination of symptoms from schizophrenia and a mood disorder (either mania or depression). In bipolar type, the mood episodes are characterized by alternating periods of mania and depression.

John's auditory hallucinations and delusions, impaired occupational and social functioning, and disorganized speech meet the criteria for schizophrenia. Additionally, his mood episodes with elation and racing thoughts, and his periods of depression suggest bipolar disorder.

A comprehensive assessment by a mental health professional, including a thorough clinical interview and review of John's symptoms and history, would be necessary to make a definitive diagnosis.