Review Question - QID 212359

A 19-year-old man presents to the emergency room after a suicidal gesture following a fight with his girlfriend. He tearfully states she is “definitely the one," unlike his numerous previous girlfriends, who were "all mean and selfish” and with whom he frequently fought. During this fight, his current girlfriend suggested that they spend time apart, so he opened a window and threatened to jump unless she promised to never leave him. His other relationships have ended in similar ways. He endorses impulsive behaviors and describes his moods as “intense” and rapidly changing in response to people around him. He often feels “depressed” for one day and then elated the next. You notice several superficial cuts and scars on the patient’s arms and wrists, and he admits to cutting his wrists in order to “feel something other than my emptiness.” His temperature is 98.7°F (37°C), blood pressure is 118/71 mmHg, pulse is 78/min, respirations are 12/min, and oxygen saturation is 98% on room air. Which of the following is the most likely diagnosis for this patient?