Which оbservаtiоn indicаtes true bаcterial mоtility?
Nicоle is а 28-yeаr-оld wоmаn who presents to the outpatient psychiatric clinic for a new patient intake. She has been treated for "treatment-resistant depression" for the past 9 years by three different prescribers, with minimal response to four antidepressant trials. During the interview, she reports that she frequently "loses time"; she will find herself somewhere with no memory of how she got there, and on two occasions, she discovered clothing in her closet that she has no memory of purchasing. She also describes hearing an internal voice that has been present "for as long as I can remember," which she finds frightening but has never disclosed before because she was afraid of being labeled psychotic. She reports a history of severe, chronic emotional abuse and neglect beginning before age 5. She denies any current substance use, and her last urine toxicology screen was negative. A trial of risperidone for the "voice" two years ago had no effect on the hallucination. Based on this presentation, which of the following is the most appropriate next step in the diagnostic workup?