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A 59-year-old man with a history of multiple concussions has been having a series of neurocognitive symptoms for the past several years. Discover more in this case.

4 Stages of Chronic Traumatic Encephalopathy

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

10 Things to Know About Narcissistic Personality Disorder

Articles

James L. Knoll IV, MD, analyzes the ethical and legal duties of psychiatrists treating substance use disorders.

Psychiatric Malpractice Grand Rounds: Addiction Psychiatry 

The costs, risks, and considerations involved in treating addiction have upped the ante, as illustrated in this case.

A Rock and a Hard Place

Doing a review of systems wasn’t “rocket science,” as they say-but it was a classic example of medical science and of why psychiatrists are physicians first.

Things Are Seldom What They Seem

Poll

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

Mini Quiz: Assessment of Malingering

Providing detailed descriptions of interactions that occurred between patient and therapist moved our field forward by both honing our technique and considering more effective ways to help our patients. But is the sharing of cases ethical?

Sharing Patient Cases: Balancing Confidentiality and Educational Needs

When, if ever, is it ethical to administer a medication to a patient-even an incapacitated one-without his knowledge? Read the case, and weigh in.

Ethics case quiz | Food for Thought

Tips for having a balanced and comprehensive risk-to-benefit discussion with competent patients who want to stop their medications.

8 Reasons a Psychotropic Medication May Be Discontinued

What factors predispose patients to TRD and what treatment strategies achieve response? Find out here, with a bonus case vignette.

6 Signs Your Patient Is at Risk for Treatment-Resistant Depression

Got a challenging case-a patient for whom the diagnosis is unclear or uncertain? Want a diagnostic opinion? This is a call for cases. Michael First, MD-a nationally recognized expert on psychiatric diagnosis and assessment issues-will review details and offer insights on select cases.

Call for Challenging Cases

Your patient is excited to be pregnant. She is currently on sertraline, and has been stable on this for many years. She is very insistent that she would like to stop her medication. What should you do?

Mini Quiz: Perinatal Depression

“Googling” a patient does not seem much different from the old-fashioned obtaining of collateral information, but the ramifications may be far more than you bargain for.

To Google or Not to Google? This Is the Question

Does this patient have decision making capacity to refuse a blood transfusion that will likely save his life? You are the ethics consultant, and the decision is yours.

Blood, Truth-and the Decision to Transfuse

Ethics case quiz: A patient's inconsistent decisions regarding treatment are cause for concern. What to do?

Of Blood and Truth

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

The Mind-Body Divide: As Seen Through a Jaundiced Eye

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

Life Lessons Learned From Addictions

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.

Clinical Considerations in Renal Failure, Depression, and Delirium

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.

Opioid Use Disorder: Update on Diagnosis and Treatment

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. 

Case Discussions

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