Haganezuka Hotaru : Sane or Insane?

Gyokko said he is not sane. Haganezuka clearly has mental problems, for better or worse. He refuse to comply with others, obsession with swords and has unpredictable mood. I am actually uneducated in this topic but he clearly has problems. This thought suddenly came when i rewatch some scenes.

Also any other characters KNY characters has mental issues? I.e Zenitsu / Inosuke haha probably Hantengu