Dr. Poyurovsky offers practical guidance for identifying and treating akathisia, a movement disorder marked by inner restlessness. He highlights the importance of psychoeducation, gradual dose adjustments, and the use of propranolol or low-dose mirtazapine for relief. He underscores the importance of distinguishing akathisia from other conditions, like psychotic agitation, to avoid unnecessary increases in antipsychotic doses.

Factitious disorder occurs when people intentionally produce or fake symptoms without clear external incentives, like financial gain or avoiding legal trouble. The goal is to adopt the “sick role” to gain attention or sympathy. It’s a tricky condition to diagnose since patients’ symptoms mimic real medical conditions. Take a nonjudgmental approach, practice supportive confrontation, and coordinate with your multidisciplinary team to ensure the patient receives appropriate care, though treatment adherence and outcomes are often poor.

Dr. Rab, pioneering street psychiatrist, shares the innovative methods he uses for effective outreach to unhoused mentally ill individuals, like mobile medication delivery and personalized housing strategies.

Alcohol withdrawal is among the most commonly encountered scenarios managed by psychiatrists in the ED. Here, Dr. Fuehrlein discusses the natural history of alcohol withdrawal, how best to assess withdrawal risk, and choose between treatment options.