A 45-Year-Old Man Comes to the Office for a Routine

A 45-year-old man comes to the office for a routine maintenance evaluation.  The patient has no prior medical or surgical history and takes no medication.  He moved to the area 3 weeks ago to work as a newscaster at a local television station.  He says, "I quit my last job while we were on-air.  I had my own show before, but then the station hired a coanchor.  There was no room for me there."  He became "extremely upset" last week when he saw an unflattering photograph of himself still featured on the station's website.  The patient then crosses his arms dramatically and describes how he had previously quit another television job abruptly after his boss told him that he was difficult to work with because he was always trying to take over meetings.  He bursts into tears and says, "I thought that he was my friend, but real friends don't stab you in the back like that."  On mental status examination, speech is loud and not pressured; facial expressions and hand gestures appear exaggerated.  Which of the following is the most likely diagnosis in this patient?

A) Antisocial personality disorder
B) Bipolar II disorder
C) Borderline personality disorder
D) Intermittent explosive disorder
E) Histrionic personality disorder
F) Narcissistic personality disorder

Correct Answer:

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