Weren't there similar issues with the guy at Virginia Tech?
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Cho's underlying psychological diagnosis at the time of the shootings remains a matter of speculation.[53] However, the lack of speech that resulted in the diagnosis of selective mutism could have been an early indication that Cho was developing schizophrenia. One symptom of schizophrenia is what is known as "poverty of speech," referring to a marked deficit in the amount of talking the person engages in. In addition, Cho's manifesto provides evidence of both paranoid and grandiose delusions. Such symptoms are also associated with schizophrenia, and it has been argued that Cho was schizophrenic.[54]
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