Question

A patient is brought into the emergency room following a fight with police. Upon examination the psychiatrist finds that the patient has a history of several discrete assaultive acts. His aggression in these situations was out of proportion to what one would consider normal. The patient has no other psychiatric disorder and no history of substance abuse. He has no significant medical history. What is his most likely diagnosis?

A. Unspecified disruptive, impulse control, and conduct disorder
B. Pyromania
C. Mania
D. Temporal lobe epilepsy
E. Intermittent explosive disorder

Answer 1

The most likely diagnosis for a patient with a history of recurrent, disproportionate assaultive acts, no other psychiatric disorders, or substance abuse is Intermittent explosive disorder.

Step-by-step explanation:

Given the patient's history of several discrete assaultive acts where aggression was out of proportion to the situation and without other psychiatric disorders or substance abuse, the most likely diagnosis is Intermittent explosive disorder (IED). This condition is characterized by sudden episodes of unwarranted anger and involves violent or aggressive behavior that is grossly out of proportion to the situation. It is diagnosed by the presence of recurrent and severe outbursts not explained by other mental disorders or substances. While epilepsy can be associated with aggression, it is typically not the sole manifestation of the condition and is accompanied by other neurological signs and symptoms that are not described in the case.