Review Question - QID 213654

A 49-year-old woman is brought to the hospital for evaluation after being arrested for shoplifting several items of trivial value from a convenience store. She has no prior medical or psychiatric history and reports feeling “fine.” She is dressed provocatively and makes sexual remarks to the physician examining her. She discloses that she was fired from her job 1 month ago after missing several weeks of work but states "None of this matters. What do I care?" The patient's husband arrives at the hospital and expresses concerns about her saying she has suddenly become hypersexual and impulsive, spending money excessively and binge eating over the last 2 months. While in the examination room, the patient grabs several bandages and cotton balls, puts them in her mouth, and urinates on the examination table. Her affect is blunted. The remainder of the psychiatric mental status exam, neurological exam, and physical exam are normal. Urine toxicology is negative. What is the most likely diagnosis in this patient?