Prompts

You are an experienced psychiatrist. Help me conduct a comprehensive initial psychiatric assessment for a patient presenting with [symptoms]. Include: chief complaint, history of present illness, past psychiatric history, medical history, family history, social history, mental status examination, and preliminary diagnostic impressions with differential diagnoses.

As a psychiatrist, help me develop a comprehensive treatment plan for a patient diagnosed with [diagnosis]. Include: pharmacological interventions (with evidence-based medication choices, dosing, and monitoring), psychotherapeutic approaches, psychosocial interventions, safety planning if needed, follow-up schedule, and measurable treatment goals.

Explain to a patient in simple, empathetic language the common side effects of [medication name], including: what to expect, which side effects are temporary vs. persistent, warning signs that require immediate medical attention, and practical strategies to manage common side effects. Use a reassuring tone while being medically accurate.

Summarize the current evidence-based literature on [topic in psychiatry]. Include: key findings from recent meta-analyses and systematic reviews, level of evidence for different interventions, areas of consensus and controversy, gaps in current research, and clinical implications for practice. Cite major studies and guidelines.

Help me write a comprehensive psychiatric progress note for a patient with [diagnosis] following today's session. Include: subjective (patient's report), objective (observations and mental status), assessment (clinical impression and progress toward goals), and plan (interventions, medication changes if any, follow-up). Use professional medical terminology while being clear and concise.

Analyze the differential diagnosis for a patient presenting with [symptoms]. For each potential diagnosis, discuss: supporting evidence from the presentation, contradicting features, additional information needed to confirm or rule out, and recommended next steps for evaluation. Prioritize diagnoses by likelihood and clinical urgency.

You are an emergency psychiatrist. Help me rapidly assess a patient presenting to the emergency department with [presenting complaint]. Prioritize: immediate safety assessment (suicide/homicide risk), acute medical causes of psychiatric symptoms, substance intoxication/withdrawal, capacity assessment, need for involuntary hospitalization, and immediate stabilization interventions. Time is critical.

Conduct a thorough suicide risk assessment for a patient with [presenting concerns]. Evaluate: current suicidal ideation (frequency, intensity, duration), specific plan and means, intent and preparatory behaviors, protective factors, past suicide attempts, psychiatric diagnoses, substance use, recent stressors, and access to lethal means. Provide risk stratification (low/moderate/high) and specific recommendations for management and safety planning.

Help me develop a management strategy for a patient with treatment-resistant depression who has failed [number] adequate antidepressant trials. Consider: optimization of current medication, augmentation strategies (lithium, thyroid, atypical antipsychotics), switching strategies, combination therapy, evidence for neuromodulation (ECT, TMS, ketamine/esketamine), psychotherapy augmentation, and addressing contributing factors (medical comorbidities, substance use, adherence issues).

Analyze potential drug-drug interactions for a patient taking [list medications]. For each significant interaction, provide: mechanism of interaction, clinical significance, expected effects, monitoring recommendations, and management strategies (dose adjustment, timing separation, alternative medications). Prioritize by severity and clinical relevance.

Help me prepare a structured case presentation for clinical supervision regarding [patient situation]. Include: brief patient demographics and presentation, relevant history, current formulation, treatment to date, specific clinical dilemmas or questions, areas where I feel stuck or uncertain, ethical considerations if any, and specific feedback I'm seeking from my supervisor.

Help me explore and understand my countertransference reactions to a patient who [describe situation]. Analyze: what feelings/thoughts arise in me, potential origins of these reactions, how they might be affecting my clinical judgment, whether they provide useful information about the patient's relational patterns, and strategies to manage them therapeutically while maintaining appropriate boundaries.

Provide evidence-based guidance for managing [psychiatric condition] in a pregnant patient currently at [gestational age]. Discuss: risks of untreated psychiatric illness to mother and fetus, safety data for relevant medications, FDA pregnancy categories and current evidence, risk-benefit analysis for continuing vs. discontinuing current medications, safer alternatives if needed, monitoring recommendations, and considerations for breastfeeding.

Help me assess an elderly patient (age [age]) presenting with [symptoms]. Consider geriatric-specific factors: cognitive screening, delirium vs. dementia vs. depression differentiation, medical comorbidities contributing to psychiatric symptoms, polypharmacy and medication interactions, fall risk, functional status and ADLs, social support and living situation, and age-appropriate medication selection with attention to anticholinergic burden and renal/hepatic function.

Help me conduct a psychiatric assessment for a [age]-year-old child/adolescent presenting with [concerns]. Include: developmental history and milestones, school performance and behavior, family dynamics and parenting styles, peer relationships, trauma history, collateral information from parents/teachers, age-appropriate mental status exam, consideration of developmental disorders vs. psychiatric conditions, and family-centered treatment planning.

Develop a comprehensive treatment plan for a patient with [substance] use disorder. Address: assessment of severity and readiness to change, withdrawal management and medical stabilization, medication-assisted treatment options (MAT), psychosocial interventions (CBT, motivational interviewing, contingency management), co-occurring psychiatric disorders, harm reduction strategies, relapse prevention planning, and coordination with addiction specialists and support groups.

Conduct a formal capacity assessment for a patient regarding [specific decision - e.g., medical treatment, discharge, financial]. Evaluate the four elements of capacity: 1) Understanding (can patient comprehend relevant information?), 2) Appreciation (does patient recognize how information applies to them?), 3) Reasoning (can patient manipulate information rationally?), 4) Expression of choice (can patient communicate a stable decision?). Provide clear documentation and recommendations.

Optimize medication management for a patient with bipolar disorder currently experiencing [mood state]. Consider: mood stabilizer selection and monitoring (lithium, valproate, lamotrigine, carbamazepine), role of atypical antipsychotics, antidepressant use and risks, managing acute mania vs. depression vs. mixed states, maintenance treatment strategies, laboratory monitoring requirements, and strategies to enhance adherence.

Analyze the differential diagnosis for a patient presenting with psychotic symptoms [describe symptoms]. Distinguish between: schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depression with psychotic features, brief psychotic disorder, substance-induced psychosis, psychosis due to medical condition, and delusional disorder. Include: key distinguishing features, necessary workup, and treatment implications for each diagnosis.

Recommend evidence-based psychotherapy approaches for a patient with [diagnosis/presenting problem]. Compare: CBT, DBT, psychodynamic therapy, interpersonal therapy, ACT, EMDR, and other relevant modalities. For each appropriate option, discuss: evidence base for this condition, key therapeutic mechanisms, typical duration and structure, patient characteristics that predict good response, and practical considerations for implementation or referral.

Develop a safe tapering plan for discontinuing [medication] in a patient who [reason for discontinuation]. Address: appropriate tapering schedule based on half-life and withdrawal risk, monitoring for discontinuation symptoms, distinguishing withdrawal from relapse, strategies to minimize withdrawal effects, when to slow or pause the taper, and contingency planning if symptoms emerge.

Conduct a comprehensive eating disorder assessment for a patient with [presenting concerns]. Evaluate: eating behaviors and patterns, body image and weight concerns, compensatory behaviors (purging, exercise, restriction), medical complications and vital signs, nutritional status, co-occurring psychiatric conditions (depression, anxiety, OCD), psychosocial functioning, and level of care determination (outpatient, IOP, residential, inpatient medical).

Develop an evidence-based treatment plan for PTSD following [type of trauma]. Include: trauma-focused psychotherapy options (CPT, PE, EMDR), medication management (SSRIs, prazosin for nightmares), addressing comorbid conditions (depression, substance use), safety and stabilization if ongoing trauma, sleep management, and coordination with other providers. Discuss timing of trauma-focused interventions and contraindications.

Develop a comprehensive case formulation for a patient with suspected [personality disorder]. Analyze: enduring patterns across situations and relationships, developmental origins and maintaining factors, core beliefs and schemas, interpersonal patterns and attachment style, coping mechanisms and defenses, impact on treatment engagement, and evidence-based treatment recommendations (DBT, MBT, schema therapy, TFP). Address countertransference and boundary management.

Develop a comprehensive treatment approach for chronic insomnia in a patient with [relevant context]. Prioritize: CBT-I as first-line treatment (sleep restriction, stimulus control, cognitive restructuring, sleep hygiene), assessment and treatment of contributing factors (psychiatric conditions, medical issues, medications, substances), judicious use of hypnotics if needed (mechanism, duration, risks), and long-term maintenance strategies.

Provide guidance for managing an acutely agitated inpatient with [presentation]. Use stepwise approach: 1) Verbal de-escalation techniques, 2) Voluntary oral medication (preferred agents and dosing), 3) Involuntary medication if needed (IM options, combinations, monitoring), 4) Physical restraints only as last resort, 5) Post-intervention debriefing and documentation. Emphasize safety, least restrictive interventions, and trauma-informed care.

Explore and address medication non-adherence in a patient with [condition]. Investigate: patient's understanding of illness and treatment, beliefs about medications, side effect burden, practical barriers (cost, access, complexity), cognitive factors, substance use, insight and motivation, past experiences with medications, and cultural/family influences. Develop collaborative strategies to improve adherence without judgment.

Assess and manage suspected catatonia in a patient presenting with [symptoms]. Use Bush-Francis Catatonia Rating Scale for screening. Address: identification of underlying cause (psychiatric, medical, medication-induced), medical complications (malignant catatonia, neuroleptic malignant syndrome), immediate treatment with benzodiazepines (lorazepam challenge and dosing), consideration for ECT if benzodiazepines fail, and monitoring for response and complications.

Develop a cultural formulation for a patient from [cultural background] presenting with [symptoms]. Using DSM-5 Cultural Formulation Interview framework, explore: cultural identity and reference groups, cultural explanations of illness (idioms of distress, perceived causes), psychosocial stressors and supports in cultural context, cultural features of patient-clinician relationship, and overall cultural assessment for diagnosis and care. Integrate cultural understanding into treatment planning.

Adapt psychiatric assessment and treatment for telepsychiatry with [patient situation]. Address: technology setup and troubleshooting, modified mental status exam via video, ensuring privacy and confidentiality, crisis management and safety planning remotely, prescribing considerations and regulations, building therapeutic alliance through screen, documentation requirements, and determining when in-person evaluation is necessary.

Interpret pharmacogenetic testing results for a patient with [diagnosis] showing [key findings]. Explain: CYP450 enzyme genotypes and their impact on medication metabolism (poor, intermediate, normal, ultra-rapid metabolizers), specific medication recommendations based on results, drug-gene interactions to avoid or monitor, appropriate dose adjustments, and limitations of pharmacogenetic testing. Integrate with clinical judgment and other factors.

Guide clozapine initiation for treatment-resistant schizophrenia. Cover: patient selection and informed consent, baseline requirements (ANC, metabolic panel, ECG, echo if indicated), REMS program enrollment, titration schedule, monitoring protocol (weekly ANC for 6 months, then biweekly, then monthly), management of neutropenia, other side effects (sedation, hypersalivation, constipation, metabolic), seizure risk, myocarditis monitoring, and strategies to optimize adherence to monitoring.

Analyze an ethical dilemma in psychiatric practice: [describe situation]. Apply ethical principles: autonomy (respecting patient's right to make decisions), beneficence (acting in patient's best interest), non-maleficence (avoiding harm), justice (fair treatment), and confidentiality. Consider: relevant laws and regulations, professional guidelines, consultation with ethics committee, documentation, and potential courses of action with their ethical implications.

Evaluate psychiatric symptoms in the context of [medical condition]. Distinguish primary psychiatric disorder from: direct effects of medical illness on CNS, medication side effects, metabolic/endocrine disturbances, delirium, psychological reaction to illness. Recommend: appropriate medical workup, collaboration with medical team, treatment modifications for medical comorbidity, and integrated care approach.

Develop a comprehensive safety plan for a patient experiencing [crisis situation]. Include: warning signs of crisis, internal coping strategies, social contacts and settings for distraction, people to ask for help, professionals and agencies to contact, means restriction (removing access to lethal means), and reasons for living. Make the plan collaborative, specific, written, and readily accessible. Schedule close follow-up.

Help me assess and address my own burnout as a psychiatrist experiencing [symptoms/situation]. Evaluate: emotional exhaustion, depersonalization, reduced personal accomplishment, contributing factors (workload, administrative burden, difficult cases, lack of support). Develop action plan: setting boundaries, seeking supervision/therapy, peer support, work-life balance strategies, meaning-making in work, and when to consider more significant changes. Normalize seeking help.