As a forensic psychiatrist who has evaluated approximately 200 defendants vis-à-vis insanity, it is my experience that it is difficult to explain a psychotic state to a jury. At a recent conference about psychiatry in the digital age, I realized video gamers live in an altered reality while playing video games, analogous to a psychotic…

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A common feature is a lack of empathy with victims. Most serial killers ​(with few exceptions) understand they are committing a crime because they take care not to be caught. Antisocial Personality Disorder and Borderline Personality Disorder commonly are present. Sadomasochism is also a common feature. Depending on the shared characteristics of the victims, the serial…

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Psychiatrist vs. Psychologist: How to Decide the Best Choice As An Expert Witness When a medical-legal question has medical aspects to emotional states or behavior, such as chronic pain, traumatic brain injury, permanent physical disability (partial disability or total disability), a psychiatrist by virtue of his or her training[1], will have expertise to understand the…

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A psychiatric disability exists when a person is mentally impaired by a psychiatric disorder.  Impairment can be partial or total, temporary or permanent, and must be taken in the context of performance of varying types of tasks.  For example, can a job be performed (or performance in a particular occupation)? Carrying out tasks of daily living?…

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A “psychiatric evaluation,” “psychiatric assessment,” “IME” (Independent Medical Evaluation) or “mental evaluation” mean the same thing: a psychiatrist evaluates the psychiatric condition of an individual in the past and/or present, in order to answer specific questions (such as those with legal implications for the person being examined).  Elements of the evaluation vary from case to case depending…

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A Will is not a contract because it does not represent a promise to perform a service or execute an action for another person (including corporations).  It is solely an allocation of a person’s wealth on death.  A contract, such as a Trust, implies the potential for an adversarial relationship if one of the parties…

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Suicidal patients exist both as in-patients and out-patients. The treater has a duty to exercise adequate skill in the diagnosis and care of such patients and an additional duty to take adequate precautions when suicidal (or other self-injurious) risk is identified. A medical malpractice may occur when there is either a failure to diagnose the…

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The terms depression and sadness are often used interchangeably, which I believe is an error. Sadness is generally experienced when there is a loss of something or someone who is held dear, but is not accompanied by feelings or hopelessness, helplessness, despair, guilt, or loss of self-esteem or self respect. Depression on the other hand…

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Many companies have employees in remote locations, domestic and foreign. When an employee becomes acutely ill from a serious psychiatric disorder and cannot travel, the problem arises to find acute care. Several options are available: Local treatment recommended by the company’s psychiatric consultant. Safe evacuation with trained medical non-psychiatric personnel (nurse or EMT). Safe evacuation…

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In order for a medical opinion to be admissible as evidence in civil, criminal and administrative cases, the basis of the opinion must fulfill either the Daubert[1] Criteria or the Frye[2] test, depending on the jurisdiction. The judge of the court rules on the admissibility of the expert opinion.  The effect of Daubert has been…

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