This review covers six medical conditions—acute intermittent porphyria, anti-NMDA receptor encephalitis, lupus, Lyme disease, neuroendocrine tumors, and syphilis—that can masquerade as psychiatric disorders. These illnesses often show up with psychiatric symptoms like anxiety, psychosis, or mood changes, mixed with physical signs such as rashes, abdominal pain, or heart irregularities. Getting the right diagnosis is essential since many cases improve with medical treatment, though you may still need to provide psychiatric care for lingering symptoms. It’s a reminder to stay curious when symptoms don’t quite fit the usual psychiatric picture.

Dr. Hendrick and Dr. Carlat are pleased to announce the upcoming publication of the Hospital Psychiatry Fact Book. 

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How long should you wait before making changes after initiating an antipsychotic? The current study tested if early efficacy on an antipsychotic predicts subsequent efficacy, and its findings indicate benefits may be observed as quickly as two weeks. 

 The negative symptoms of schizophrenia are notoriously difficult to address with traditional treatments. The meta-analysis suggests TMS can significantly improve negative symptoms and may offer a promising new treatment approach.

Malingering, deceptive, or disruptive patients: what do you do when you encounter a patient who is resistant to discharge yet does not exhibit a clinical need for continued inpatient care? In this article, we review the key steps of the administrative discharge process.