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Challenging Cases

About Challenging Cases

The cases here are culled from the real-life experiences of the authors, and some have previously been published in Psychiatric Times within the context of a clinical article. The identity of the patients in each of these cases has been altered. We feature them here because each case involves at least one diagnostic or therapeutic decision dilemma. We invite you to weigh in on the case vignettes presented in this space.

Do you have a challenging case? Send us the details at editor@psychiatrictimes.com. Please describe the clinical presentation, assessment, treatment, and outcome, followed by a compelling question to challenge readers.

Challenging Cases

Lack of empathy is a commonly known feature of narcissistic personality disorder. Romantic relationships are typically shallow and difficult for to maintain. What are some other features of NPD? More in this case presentation.

While opioid dependence is among the most severe and lethal of addictions, it also has the most effective medication treatments. The authors provide 2 case vignettes and a step-by-step process for clinical decision making.

gambling disorder

The loss of control over urges and behaviors may be the central component of gambling disorders, but there is so much more to consider. Individuals with these problems have exponentially higher rates of suicide attempts and completions.

©jslavy-shutterstock

Is it possible to add creative twists to proven therapeutic techniques in order to encourage reluctant patients to try safe and effective treatments that we believe can benefit them? After reading the case, tell us what you think.

A 28-year-old married mother of 2 with a history of depression is brought to the emergency department after 6 months of near-daily methamphetamine use.

In clinical terms, one of the most distinguishing diagnostic features of addictive disorders is that those affected continually and repeatedly revert to their addictive behaviors, despite the devastating negative and adverse consequences.

Phenomenology in an Acute Care Setting

We present the case of a patient for whom different attending providers had markedly different interpretations. As the case unfolds, we invite you to reflect on your diagnostic understanding of each presentation.

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