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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

Depression is a frequent psychiatric comorbidity among patients with restless leg syndrome. The case presented here illustrates the importance of evaluating for RLS symptoms in patients with major depressive disorder who complain of insomnia.

After thorough examination and history-taking, bipolar II disorder was suspected in a 19-year-old college student. What psychiatric screening tools might be used to further confirm the diagnosis for this patient?

Psychiatrists have found ways to bring their expert skills and knowledge to the care of medically ill patients who are nearing the final phase of life.

Case-based dialogues illustrate some virtues required in psychiatric practice.

During the first year of her child and adolescent psychiatry fellowship, this psychiatrist received an invaluable lesson regarding the importance of “treating the whole patient” in this case, a 16-year-old patient who is pregnant.

This case study of a 21-year-old female—referred by a relative because of longstanding severe interpersonal, academic, and occupational impairment—illustrates the importance of screening patients with brief episodes of depression for mixed features.

As practicing physicians, we constantly ask ourselves when and where to alert patients to bad possibilities that may occur in the future. More in this installment of "Why Psychiatrist Are Physicians First," by Sharon Packer, MD.

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