LAUSR

Presenting Problem Mr. R is a 23-year-old, single Caucasianmale from theMidwest, on leave of absence from an elite university, with a history of various previous diagnoses (including depression, bipolar disorder, psychosis not otherwise specified, attention-deficit/ hyperactivity disorder, and frontal lobe decline) and three psychiatric hospitalizations (including two in the preceding month). After impulsively flying in from out of state to petition his dean for reentry, Mr. R was brought to a Boston-area emergency department by university police. In the emergency department he was calm but lacked insight regarding his actions. He demonstrated signs of thought blocking, with flattened affect and increased speech latency. He was admitted to our inpatient psychiatric unit under Section 12 of the Massachusetts General Laws (involuntary three-day hold).