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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

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.

The Interface of Dermatology and Psychiatry

Delusional parasitosis can be difficult to recognize, but timely diagnosis and psychiatric treatment can improve quality of life and reduce medical costs.

A case report of an acute, transient, reversible depression prompts us to think in a different way about depression.

The psychiatrist’s role is to act as a consultant to maximize the likelihood of a successful taper and discontinuation and to minimize collateral morbidities or withdrawal complications. This slideshow features common scenarios in which a planned discontinuation of psychotropic medications occurs.

This case of a 14-year-old female patient with end-stage cystic fibrosis illustrates the psychiatrist's critical role in ensuring quality end-of-life care.

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