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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

The reported severity of the complaints in this patient appears grossly out of proportion given gathered information and clinical observations. What's your diagnosis?

Psychiatrists increasingly recognize that not all treatments for depression are created equal—but in this case, an entirely different diagnosis came to light.

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A reminder that success in life requires paying attention to the basics, starting with showing up and hanging in there.

Renal failure is not an uncommon disorder either in the general public or in patients with psychiatric disorders, but accompanying depression, anxiety, and loss must be attended to during such an illness.

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.


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