Sudden-Onset Behavioral Disturbance in a Woman with No Prior Psychiatric, Medical History

Mrs. M is a 30-year-old, married, African-American woman with no prior history of mental illness who was initially admitted to a general hospital due to changes in behavior. Mrs. M’s husband reported that during the 2 days prior to her admission, she seemed to have difficulty paying attention and registering information; she would sometimes talk excessively and at other times would stare blankly and not engage in any conversation with her husband. She also experienced insomnia and was intermittently restless. When she initially arrived at the general hospital, she was agitated and was given a one-time dose of ziprasidone 20 mg orally to calm her down. While at the general hospital, the patient was also selectively mute. The initial medical work-up in