That kind of paranoia leans way more schizophrenic than guilt. All of the feared possibilities listed are very stereotypical and movie like, which is a pretty common thing paranoid schizos do.

Normally, its someone extremely religious who becomes that kind of person seeing witches and Satan in everything in their schizo psychosis, but if someone had a break from their Faith in the past then I can see it manifesting as a deep seated terror of being the apostate under threat like that.

This guy had a long list of mental health incidents prior, and seemed to have normal functioning enough just a few weeks ago to happily celebrate his anniversary. A guilt mind growing increasingly afraid wouldn't do that.