In this session, we will discuss a challenging case of a 35 year old female with a history of MS and normal premorbid functioning, who presented with new onset psychosis. During the course of this patient's hospital visits, many challenging forensic and medical dilemmas faced our team:1) Where does the primary treatment belong? Neurology, psychiatry or both? And what is the standard of care?2) What aspects of this patient's presentation argued against a primary psychiatric disorder ie. age of onset, normal premorbid functioning, atypical presentation.3) If the etiology was found to be fully attributable to, or at least partially, to MS, can treatment of MS be considered on an involuntary basis due resultant danger to others?
Learning Objectives:- The subtle differences in the presentation of medically induced psychiatric presentations vs. primary psychiatric illness.
- General principles in the treatment of medically induced psychiatric illness.
- The forensic considerations of involuntary hospitalization and medication over objection.
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