New calls for a tightening of diagnostic criteria in psychiatry: Feeling "down" only 2 weeks after a loved one dies now qualifies as major depression, and many older patients are getting psychotropic medications with no diagnosis at all.
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.
Mr M's diabetes remained stubbornly uncontrolled despite all appropriate clinical interventions. The day I read his first psychiatric hospital admission history I was stunned to see on paper what we had all missed in the flesh. What value is adherence to treatment in the face of sheer hopelessness?