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Hal S. Wortzel, MD

Hal S. Wortzel, MD

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The term “CTE” was introduced recently to describe progressive neuropathological changes and diffuse neuropsychiatric symptoms associated with a history of TBI. Here, a clinical overview of TBI and CTE.

The foreword to the Textbook of Vio­lence Assessment and Management promptly reminds readers that the mental health system has been invested in the prediction and prevention of violence since its inception. In a field dedicated to promoting wellness via the management of cognition, emotion, and behavior, violent thoughts, feelings, and actions are of primary concern. When psychiatric illness or psychological distress manifests as violence, the costs in terms of human suffering are extreme, wreaking havoc in the lives of patients, clinicians, and society at large—often with irrevers­ible consequences.

The role of the forensic psychiatrist frequently requires straddling a fence. On the one side lie the standard function and commensurate ethics of a physician; on the other are the needs of the legal system calling for objectivity, truth, and justice.

Among the numerous challenges facing psychiatric care providers today, few experiences are as ubiquitous as treatment refusal. Tragically, it is often the case that the very patients who are most inclined to refuse treatment are the ones who are in most need of it.

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