Challenging Cases

Patients with borderline personality disorder or narcissistic personality disorder (or both) can feel entitled to special treatment and often seek only approving forms of attention from those who treat them. How would you help this patient?

What are the options for treating major depressive disorder in children and adolescents? This case offers readers a chance to give their feedback and to interact with the authors, who will present teaching points based on your comments.

A parent's heavy drinking can increase a child's risk of substance use disorder. This case illustrates strategies to encourage a parent to disclose information about her drinking.

This case describes a man with Down syndrome who, after an accident, sustained minor brain trauma. Subsequently, he regressed to a rage state he had experienced when he was younger.

Here we present the case of Mr P, a 40-year-old man with bipolar disorder and substance use disorder, including his symptomology, treatment subsequent to hospitalization, concerns for risk, and the outcome.

Patients with eating disorders like anorexia nervosa are resistant to treatment. This case briefly outlines a treatment approach using a community-based, patient-centered model of care.

In treating a female who sexually abuses a minor, what should the clinician keep in mind? Is the treatment plan different for a female offender than a male?

These vignettes are based on real cases which I have either been involved with as the therapist or as the supervisor or I have read about them or have been told about them by a colleague.

This patient initially initially presented to outpatient psychiatric care for severe temper outbursts—rages precipitated by minor issues. Learn how diagnostic accuracy can be significantly enhanced through the use of structured psychiatric interview tools.

Educated and successful individuals, Mr H's children seem able to understand that their father can no longer make his own decisions, but they continue to defer to him for medical and disposition decisions stating, “whatever he wants to do.”