A 26-year-old chemistry graduate student is brought to the emergency department after throwing a punch at his roommate. The patient insists that he must return home to study for his upcoming examinations, quickly becoming angry and belligerent with staff members when they refuse to let him leave. He claims that he has been studying “like a fiend” for the past 3 weeks. The patient’s best friend reports that the patient has not slept in days, and he has lost at least 10 lb. The patient has no medical or psychiatric problems of which his friend is aware.
Physical Examination : On a physical examination, the patient is found to have a blood pressure of 140/94 mm Hg and a pulse rate of 100/min. His pupils are dilated, he is sweaty, and he has a fine tremor in both hands. The results of the rest of the physical examination are normal, although the patient is uncooperative. Mental Examination…
