Clinical Case DiscussionsCommentary: Diagnostic ChallengesGarakani, Amir MD Author Information GARAKANI: Department of Psychiatry and Behavioral Health, Greenwich Hospital, Greenwich, CT; Department of Psychiatry, Yale University School of Medicine, New Haven, CT The author declares no conflicts of interest. Please send correspondence to: Amir Garakani, MD, Chair, Department of Psychiatry and Behavioral Health, Greenwich Hospital, 5 Perryridge Road, Greenwich, CT 06830 (e-mail: [email protected]). Journal of Psychiatric Practice: May 2022 - Volume 28 - Issue 3 - p 270-271 doi: 10.1097/PRA.0000000000000630 Buy Metrics Abstract The 3 cases presented in this issue highlight diagnostic challenges in evaluating and treating patients with complicated presentations. The first case involved a man with mild neurocognitive disorder due to Alzheimer disease accompanied by depressive and anxiety symptoms and what appeared to be previously undiagnosed attention-deficit/hyperactivity disorder. The second case involved an unusual case of shared psychotic disorder involving a woman with a primary diagnosis of bipolar disorder and her husband with posttraumatic stress disorder. The third case involved a patient with a history of multiple diagnoses who presented with catatonic symptoms, obsessive-compulsive disorder characterized by religious scrupulosity, and some features of obsessive-compulsive personality disorder. These reports illustrate the challenges in evaluating and treating patients whose clinical presentations may not fit neatly into a diagnostic category or that have a nontraditional presentation. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.