Psychiatry blog
Clinical teaching and practical ideas for your next study session.
Adolescent Aggression: Breaking the Coercive Family Cycle
When a teen’s outburst ends a caregiver’s demand, immediate relief may reinforce both sides. Learn to map the cycle and plan safer, more consistent responses without blaming the family.
After a Teen Discloses Cutting: Balancing Safety, Privacy, and Family Support
A teen may describe cutting as pressure relief, but neither a fixed relief-to-shame cycle nor the stated function settles suicide risk or caregiver disclosure. Learn how to assess safety, explain confidentiality limits, and involve a safe adult collaboratively—including when active suicidal ideation calls for disclosure.
After No Acute MI Is Identified: Discussing Panic-Like Chest Symptoms
Repeated reassuring emergency evaluations do not necessarily make a patient feel safe—or establish a psychiatric diagnosis. This case discussion shows how to validate chest symptoms, explain what prior tests do and do not establish, and build a shared follow-up plan without dismissing medical risk.
Oxybutynin and Delirium: Linking Muscarinic Blockade to Acetylcholine
A recent oxybutynin prescription points to reduced central cholinergic signaling—the classic delirium hypothesis. For boards, connect receptor blockade to acetylcholine; in practice, treat the timeline as a reason to review medications, not proof of a single cause.
ICD-11 Complex PTSD: The DSO Clusters That Change the Diagnosis
Early trauma and relationship difficulties can raise suspicion for complex PTSD, but they are not the diagnosis. Learn how to assess the PTSD core, all three DSO domains, and functional impact.
One Patient, Two Episodes: Reassessing FND After Intentional Illness Induction
Documented intentional insulin induction may support a later factitious-disorder formulation if the full criteria are met. It does not, by itself, prove that earlier functional weakness was deliberate.
Olanzapine and Insulin Resistance: How Specific Should a Board Answer Be?
A direct-mechanism MCQ can tempt you to state more than the evidence supports. Learn the classic insulin-signaling answer, distinguish a cell-model finding from a small human physiology study, and avoid treating a proposed GLUT4 effect as a universal explanation.
Violence Risk Formulation: From Risk Factors to Scenarios
Turn a vague “high risk” label into a time-bound, target-specific account of what could happen, under what conditions, and what could reduce the risk.
Self-Injury in Borderline Traits: Function, Intent, and Treatment
A patient self-injures after a relationship rupture and says she wanted to feel real, not die. Learn to assess the function of that episode without confusing it with suicidal intent or diagnosing borderline personality disorder from self-injury alone.
Wisconsin Card Sorting Task: Localize the Pattern, Not the Test
When a psychiatry MCQ pairs working-memory difficulty with perseverative set-shifting, use the task demands to choose dorsolateral prefrontal cortex—and separate that board-level localization from a real-world lesion diagnosis.
Dementia and Firearms: Assess Access Before a Crisis
A focused guide to assessing firearm access in dementia: look beyond the diagnosis to current abilities, behavior, household access, and a realistic safety plan.
After the Drowsy-Driving Near-Miss: Delayed Sleep-Wake Phase Disorder, Hypnotics, and Bipolar Safety
A patient with bipolar disorder and a delayed sleep schedule has a drowsy-driving near-miss after sedative use. Learn why stronger hypnotics do not correct the underlying timing problem, how to triage driving risk, and how to advance the clock while monitoring for mood destabilization.