Cluster A personality disorders Quiz: Ace Your Exams

A 30-year-old man is brought to the emergency department by the local paramedics after a motor vehicle accident. The patient is conscious and has minor lacerations over the right forearm. On further questioning, the patient says, “I was passing by a big sale on car tires, and then later on, I was involved in an accident caused by tire failure. That store was selling new tires, and therefore, other tires had to fail.” The patient believes he has a “sixth sense” which enables him to predict bad events before they happen. He lives alone at home and says, “I prefer it this way.” Past medical history is unremarkable. Vitals are within normal limits. Physical examination reveals a middle-aged man with multiple lacerations on the right forearm. On mental status examination, it is noted that the patient is wearing undergarments on the outside and multiple layers of mismatched clothing underneath. The patient has a flat affect and avoids eye contact. Which of the following is the most likely diagnosis?