A, a 35-year-old nonbinary patient with a complex psychiatric history, including major depressive disorder with psychotic features, attention deficit hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), who developed tardive dyskinesia (TD) following stimulant (amphetamine/dextroamphetamine) initiation, which improved significantly after discontinuing the stimulant and switching to quetiapine. The case highlights the challenges of managing TD in patients with overlapping psychiatric conditions and polypharmacy, emphasizing the role of stimulants in exacerbating movement disorders. A review of stimulant-induced movement disorders underscores their association with tics, dyskinesia, and TD, particularly in ADHD populations. We discuss treatment strategies, including VMAT2 inhibitors (e.g., valbenazine), antipsychotic switches (e.g., clozapine, quetiapine), and adjunctive therapies (e.g., vitamin E). The report advocates vigilant monitoring, early intervention, and individualized approaches for TD in high-risk patients.

Catatonia is prevalent in the general hospital yet remains under-recognized. Of particular interest is the relationship between delirium and catatonia as recent studies have shown catatonia may co-occur with delirium. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision posits that catatonia does not exist in delirium, although studies have questioned this exclusion.

We present a case of a middle-aged man brought to the hospital for altered mental status and hallucinations in a background of chronic alcohol use. Top experts in the consultation-liaison field provide guidance for this commonly encountered clinical case based on their experience and a review of the available literature. Key teaching topics include a differential for and distinguishing features of hallucinations in the setting of alcohol use, risk stratification and selection of agents for alcohol withdrawal management, and prevention of neurological injury in Wernicke-Korsakoff. Specifically, the differential diagnosis for hallucinations in alcohol withdrawal syndrome contains delirium in addition to delirium tremens as many patients do not progress to severe withdrawal syndrome. Symptom triggered protocols for alcohol withdrawal may be less reliable in general hospital settings due to limitations such as confounding medical comorbidities, and selecting an agent for management is based on clinical presentation, properties of the agents, and risk of severe symptoms.

Parkinson's disease (PD) is a chronic, progressive neurodegenerative disorder commonly affecting adults. Demoralization refers to a state characterized by feelings of hopelessness, helplessness, existential distress, a persistent sense of inadequacy, or a perceived inability to meet personal or societal expectations. This study aimed to identify factors associated with demoralization in patients with PD.

Anorexia nervosa (AN) in older adults presents with medical complexity, psychiatric comorbidity, and diagnostic ambiguity, often overlapping with depression, cognitive decline, or anorexia of aging. A literature base dominated by case reports limits practical guidance for consultation-liaison (C-L) psychiatry.

Psychological care for patients with serious illness is recommended; however, established quality indicators for this care are lacking.

Psychiatric symptoms have been reported with certain biologic and novel systemic therapies for psoriasis and inflammatory bowel disease, but the extent and nature of these effects remain unclear. We summarize the literature and present 2 illustrative cases to highlight potential associations.

Heart failure (HF) affects over 6 million US adults, especially older individuals, and is a leading cause of hospitalization with high readmission rates. Psychological distress, particularly depression, is common and linked to negative outcomes.

Emergency department (ED) patients requiring inpatient psychiatric admission experience prolonged boarding times due to a nationwide deficit in inpatient bed capacity. These extended boarding times, which can last hours to days, introduce additional risks of harm, including missed home medications and omissions in care essential to chronic disease management. The overall aim is to reduce missed care components in ED patients with psychiatric illness awaiting inpatient psychiatry admission by using our novel checklist and mnemonic, sugar control, home medications, expiration time, documentation, social work, and psychiatry consults, coupled with an educational campaign.

The severity of suicide risk in patients who present to the emergency department (ED) with co-occurring complaints of suicidal ideation and alcohol intoxication is neither well-understood nor well-recognized by ED staff. While suicide screening has become a standard expectation in ED care, there lacks consensus on standard care practices for the evaluation and management of patients with suicidal ideation and/or attempt and alcohol intoxication.

Acute urinary retention (AUR) is a well-known urologic emergency with potentially catastrophic consequences, but is not typically thought of as a complication of catatonia. AUR is a urologic emergency that occurs when the patient is unable to pass urine voluntarily and is not in the The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for catatonia.

Factitious disorder is a rare condition that is important to recognise and treat appropriately. Patients with eating disorders can present seeking care for self-induced illnesses such as complications of purging and deliberate self-harm, the origins of which may not be disclosed by the patient. Rarely, patients will also present self-reporting a history of an eating disorder where there is evidence that this has been fabricated or exaggerated.

Higher body mass index (BMI) generally increases susceptibility to certain diseases. However, previous studies have shown that metformin, a medication for type 2 diabetes mellitus (T2DM), can improve various outcomes, including survival in obese patients. This indicates that the effectiveness of metformin on certain outcomes is more pronounced in those with a higher BMI. It remains unclear if the effects of metformin on delirium risk differ according to BMI.

Clozapine is an atypical antipsychotic for treatment-resistant schizophrenia. Despite its efficacy, it is associated with many serious side effects, including pericarditis. Clozapine-associated pericarditis may range from mild symptoms to life-threatening complications. Despite increasing case reports, a comprehensive synthesis is lacking, necessitating a systematic review.

An increasing body of evidence indicates that peripheral vestibular disorders (PVDs) are associated with depressive disorders. However, further investigation is required to elucidate the temporal and causal relationships between the aforementioned disorders.

Catatonia is a neuropsychiatric disorder characterized by motor, affective, cognitive, and behavioral disturbances. Despite its association with significant healthcare costs, morbidity, and preventable mortality, catatonia remains underdiagnosed, particularly in emergency department (ED) settings. Limited data exist on the demographics, diagnostic patterns, and outcomes of catatonia in the ED. This study aims to characterize the epidemiology and healthcare utilization of ED visits associated with catatonia using the National Emergency Department Sample.